Maternal influenza vaccination intention and associated factors among pregnant women in Guizhou Province, China

Despite global recommendations, maternal influenza vaccination coverage in China remains critically low. This hospital-based cross-sectional study (January–February 2022) applied the Health Belief Model (HBM) to examine determinants among 564 pregnant women in Guizhou Province. Mann-Whitney U tests and modified Poisson regression were employed to compare inter-group distributions and estimate prevalence ratios (PRs). Analysis revealed only 11.9% (67 of 564) of respondents received pre-pregnancy vaccination, and 36.7% (207 of 564) intended to be vaccinated during pregnancy. Key HBM-based predictors of vaccination intention included: (i) perceived barriers, primarily fetal/maternal safety concerns and familial opposition; (ii) cues to action and perceived benefits; and (iii) perceived susceptibility and severity. PRs and 95% CIs across quantiles indicated statistical significance in influenza vaccination intention by levels of perceived barriers (contrast = –0.34; 95% CI: −0.51, −0.17; Ptrend Ptrend = 0.002). These context-specific determinants provide the basis for our intervention strategies and measures. Integrated interventions, such as prenatal counseling, mobile health education, financial incentives, peer networks, and reminders, may enhance maternal influenza vaccination coverage, warranting broader implementation.尽管全球已发布相关推荐指南，但中国的孕产妇流感疫苗接种覆盖率仍处于极低水平。本项基于医院的横断面研究（2022年1-2月）以健康信念模型（Health Belief Model, HBM）为分析框架，对贵州省564名孕妇的流感疫苗接种影响因素展开探究。研究采用曼-惠特尼U检验（Mann-Whitney U tests）与修正泊松回归（modified Poisson regression），对比组间分布差异并估算患病率比（PRs）。分析结果显示，仅11.9%（564名受访者中的67人）在孕前完成流感疫苗接种，另有36.7%（564名受访者中的207人）表示愿意在孕期接种疫苗。基于健康信念模型的接种意愿关键影响因素包括：（i）感知障碍，主要为胎儿/孕产妇安全顾虑与家庭反对；（ii）行动线索与感知收益；（iii）感知易感性与感知严重性。分位数层面的患病率比及95%置信区间（95% CIs）结果显示，不同感知障碍水平下的流感疫苗接种意愿存在统计学显著性差异（对比值=-0.34；95% CI：-0.51, -0.17；趋势检验P=0.002）。这些贴合特定场景的影响因素为我们制定干预策略与措施提供了依据。诸如产前咨询、移动健康宣教、经济激励、同伴支持网络以及接种提醒等整合式干预手段，或可提升孕产妇流感疫苗接种覆盖率，值得进一步推广实施。