Pharmacists' knowledge, attitudes, and practices regarding influenza vaccination and treatment of pregnant women

Objectives: To understand pharmacists' knowledge, attitudes, and practices regarding vaccination and treatment of pregnant women for seasonal influenza and pandemic 2009 influenza A (H1N1). Design: Descriptive, exploratory, nonexperimental study. Setting: United States between January 21, 2010, and February 9, 2010. Participants: 606 pharmacists who participated in the American Pharmacists Association (APhA) Immunization Certificate Training Program and practice in chain, supermarket, mass merchandise, and independent pharmacies. Intervention: Electronic survey sent by APhA to 7,356 pharmacists who had participated in its Immunization Certificate Training Program. Main outcome measures: Pharmacists' knowledge, attitudes, and practices regarding vaccination and antiviral treatment of pregnant women for seasonal and H1N1 influenza. Results: Respondents were more likely to recognize that pregnant women are at an increased risk associated with H1N1 influenza (85%) than to recognize the increased risk associated with seasonal influenza (78%). However, respondents were less likely to believe that they have an important role in vaccinating pregnant women compared with the general public (82% vs. 97%) and less likely to agree that 2009 H1N1 vaccine was safe during pregnancy compared with the seasonal influenza vaccine (78% vs. 87%). Pharmacists who had been vaccinated themselves were more likely to recommend vaccination for pregnant patients. Only 38% believed that antiviral medications such as oseltamivir can be given during pregnancy because the benefits outweigh the risks. However, in response to case studies of pregnant women who were candidates for antiviral medications, respondents indicated that they would take extraordinary steps to ensure that pregnant women were either referred for medical assessment or for assistance in obtaining prescribed antiviral medications. Conclusion: Education efforts that focus on the effectiveness and safety of influenza vaccination during pregnancy and the benefits of treating pregnant women with confirmed or suspected influenza with antiviral medications may be useful in improving pharmacists' support of pharmaceutical interventions to reduce the impact of influenza in pregnant women. Pharmacists' personal decisions regarding vaccination may be a marker for their overall assessment of risks and benefits and may influence their recommendations for pregnant patients.