Risk perceptions, worry, or distrust: What drives pregnant women's decisions to accept the H1N1 vaccine?

To determine how risk perceptions, worry, and distrust relate to pregnant women's intentions to accept the H1N1 vaccine. Cross-sectional survey of 173 pregnant women recruited from two OB/GYN practices at an urban academic medical center. Survey items were adapted from validated measures of risk, worry, and health care distrust. Vaccination intention was analyzed as a dichotomous variable. Analyses were with student's t tests, chi squared tests, and logistic regression. Study participants were, on average, 25.6 years old with parity = 2.8. 55% of respondents were Black; 32% completed a high school diploma or less; and half were publically or un- insured. 63% of the respondents reported that they "definitely" or "probably" would accept the H1N1 vaccine. Intention to receive the H1N1 vaccine did not vary by sociodemographic factors nor by source of health information. In univariate analysis, intention was related to higher risk perceptions about probability of and susceptibility to H1N1 influenza (57.9 vs. 31.8%, P = .001 and 67.0 vs. 45.3%, P = .005, respectively), worry about getting H1N1 influenza (48.1 vs. 15.6%, P = <.001), and less distrust in the health care system (mean score 1.07 vs. 1.51, P < .001). In multivariable analysis, only worry about getting H1N1 was related to vaccination intention (OR = 3.43, P = .04). Worry about acquiring disease was a stronger predictor of vaccine intention than risk perceptions, distrust, or worry about vaccine safety. With growing numbers of vaccines being offered during pregnancy and immediately postpartum, these results have important implications for future vaccination intervention, education, and messaging efforts in urban settings.