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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Public Health 1/2015

Surveillance of antenatal influenza vaccination: validity of current systems and recommendations for improvement

BMC Public Health > Ausgabe 1/2015
Annette K. Regan, Donna B. Mak, Hannah C. Moore, Lauren Tracey, Richard Saker, Catherine Jones, Paul V. Effler
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests to disclose.

Authors’ contributions

AKR conducted data analysis and managed report writing; DBM managed data collection, advised on analysis and report writing; RS and CJ managed data collection at antenatal care sites; HCM, LT, RS, CJ, and PVE each advised on data analysis and report writing. All authors read and approved the final manuscript.



Although influenza vaccination is recommended during pregnancy as standard of care, limited surveillance data are available for monitoring uptake. Our aim was to evaluate the validity of existing surveillance in Western Australia for measuring antenatal influenza immunisations.


The self-reported vaccination status of 563 women who delivered between April and October 2013 was compared against three passive data collection sources: a state-wide antenatal influenza vaccination database maintained by the Department of Health, a public maternity hospital database, and a private health service database. Sensitivity, specificity, and positive and negative predictive values were calculated for each system using self-report as the “gold standard.”


The state-wide antenatal vaccination database detected 45.7 % (95 % CI: 40.1–51.4 %) of influenza vaccinations, the public maternity hospital database detected 66.7 % (95 % CI: 55.1–76.9 %), and the private health service database detected 29.1 % (95 % CI: 20.5–39.4 %). Specificity exceeded 90 % and positive predictive values exceeded 80 % for each system. Sensitivity was lowest for women whose antenatal care was provided by a private obstetrician.


Existing resources for surveillance of antenatal influenza vaccinations detect 29–67 % of vaccinations. Considering the importance of influenza immunisation as a public health intervention, particularly in pregnant women, improvements to routine monitoring of influenza vaccination is warranted.
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