Vulnerable groups within a vulnerable population: awareness of the A(H1N1)pdm09 pandemic and willingness to be vaccinated among pregnant women in Ivory Coast.

BACKGROUND: Because little is known about attitudes toward influenza and influenza vaccine among pregnant women in West Africa, before local distribution of A(H1N1)pdm09 vaccine in Ivory Coast we assessed knowledge of the pandemic and acceptance of the A(H1N1)pdm09 vaccine in a diverse population of pregnant women.
METHODS: A cross-sectional intercept survey of 411 pregnant women in 4 prenatal care settings was conducted during 15-28 February 2010 in Abidjan, Ivory Coast.
RESULTS: The majority (64.5%) of pregnant women said they had heard of the influenza pandemic, and of these, the majority (61.3%) were aware of the A(H1N1)pdm09 vaccine. However, awareness varied significantly by clinical setting, education level, and access to media (P < .001 for all comparisons). After adjustment for other sociodemographic factors, college-educated women were 16.8 (95% confidence interval [CI], 3.3-85.2) times as likely as women without formal education to be aware of the pandemic. After controlling for both education and demographic characteristics, women with televisions were 5 times as likely as women without television to be aware of the pandemic (adjusted odds ratio [aOR], 4.94; 95% CI, 1.34-18.17). Of those aware of the influenza pandemic, 69.8% said they would accept the A(H1N1)pdm09 vaccine while they were pregnant. Although awareness was highest in private prenatal care clinics, compared with public outpatient clinics (90.6% vs 37.5%), acceptance of vaccine was significantly lower in private settings, compared with public outpatient settings (57.3% vs 87.2%; P < .001 for each comparison).
CONCLUSIONS: Gaps in knowledge about the influenza pandemic and vaccine highlight the challenges of pandemic preparedness in poorer countries, where substantial disparities in education and media access are evident.