Although the Thai Advisory Committee on Immunization Practices
expanded influenza vaccine recommendations to include
pregnant women as a high priority group in 2009, seasonal
influenza vaccine coverage among Thai pregnant women was
reported to be only 0.9–1.1% during 2010–2012, and much lower
than other high risk groups [14]. Vaccination coverage among Thai
pregnant women may be low for several reasons. First, access may
be insufficient, since national influenza vaccine supplies are limited
and are determined by estimates of the number of persons with
chronic diseases without accounting for pregnant women as a separate
risk group. Each year, the Thai government purchases 3.5
million doses of vaccine, whereas the population of Thailand is 66
million with approximately 10 million persons with chronic disease
and 700,000 pregnant women [14]. Thus,the government may
wish to consider the number of pregnant women each year when
purchasing influenza vaccine to increase influenza vaccine coverage.
Second, we found that healthcare provider recommendations
were an important cue to action for influenza vaccine acceptance
among Thai pregnant women, but only 25% of pregnant women
had received a healthcare provider recommendation for influenza
vaccination. Improving access to influenza vaccines by increasing
the supply of government-funded vaccine available each year
and increasing healthcare provider awareness of the importance
of recommending influenza vaccination to pregnant women might
increase vaccination coverage rates among Thai pregnant women.