Date of Award


Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Dr. Emily Graybill

Second Advisor

Merrilee Gober



INTRODUCTION: Influenza is a public health concern each influenza season in the United States (US). Annually, about 50,000 people die due to influenza complications in the US. Pregnant women and children under the age of five are two of the most at-risk groups for influenza-related morbidity and mortality. Since 2004, the Centers for Disease Control (CDC), the Advisory Committee on Immunization Practice (ACIP), and the American College of Obstetricians and Gynecologists (ACOG) have recommended that women who will be pregnant during the influenza season get vaccinated. Vaccination of mothers also protects infants for up to the first six months of life through the active transfer of maternal antibodies in the womb. Vaccination during pregnancy is safe and is the most effective way for mothers to protect themselves and their infants from the influenza virus.

PURPOSE: Vaccination rates among pregnant women in Georgia are low, despite the CDC, ACIP, and ACOG recommendation to be vaccinated for influenza during pregnancy. In 2013, only 23.7% of women in Georgia received an influenza vaccine before or during pregnancy, a number well below the national average of 55.3% for the same year. The purpose of this study is to determine which factors are positively associated with influenza vaccine uptake during 2 pregnancy in Georgia through an analysis of the 2015 Georgia Vital Events Information System (VEIS) Birth Worksheet. The author believes that by identifying which factors show an increase in vaccine uptake, clinicians will be able to beneficially direct vaccine promotion efforts among pregnant women in Georgia.

METHODS: Secondary data from the 2015 VEIS Birth Worksheet was obtained from the Georgia Department of Public Health. 130,133 women between the ages of 18 – 49 completed a Birth Worksheet in 2015 and were included in the study. Variables used for regression analysis, descriptive analysis, and prevalence of vaccine uptake include: age, race, education level, perinatal region of residence, and receipt of prenatal care. An extensive review of existing literature was also conducted.

RESULTS: The prevalence of influenza vaccine uptake among pregnant women varied across the variables. 13.39% of women who completed a Birth Worksheet in 2015 reported that they received an influenza vaccine during pregnancy. The prevalence of vaccine uptake was highest among white women (65.26%), women between the ages of 25 – 34 (60.16%), women with a college degree (51.03%), and women living in the Atlanta perinatal region (44.52%). Surprisingly, of all the Atlanta region respondents, only 10.32% received an influenza vaccine despite having the largest population of all the regions in Georgia. Almost all women who received an influenza vaccine during pregnancy also received prenatal care (98.48%). Of the 115,443 women who received prenatal care, 14.87% received an influenza vaccine.