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CONTEXT: Pregnant women are at increased risk of severe influenza-related complications and hospitalizations and are a priority group for influenza vaccination. OBJECTIVE: To examine coverage of seasonal and pandemic influenza A (H1N1) vaccines in pregnant women in a managed care setting, from 2008 to 2012. DESIGN: Retrospective cohort study of 10,145 pregnant women. MAIN OUTCOME MEASURES: H1N1 and seasonal influenza vaccination rates. RESULTS: Seasonal influenza vaccine coverage increased from 38% to 63% between the 2008-2009 and 2010-2011 seasons, and then dropped to 61% in 2011-2012. Vaccine coverage was higher in women considered at high risk of influenza complications, increasing from 43% in 2008-2009 to 71% in 2010-2011, before decreasing to 69% in 2011-2012. H1N1 vaccine coverage was greater than seasonal influenza coverage in 2009-2010 in the overall pregnant population (61% vs 53%) and in the high-risk group (64% vs 59%). We observed statistically significant differences in vaccination rates by trimester, gravidity, maternal age, and race/ethnicity. CONCLUSIONS: Vaccination rates increased significantly from 2008 to 2011, then dropped slightly in 2011-2012. Continued efforts are needed to ensure adequate vaccination coverage in this high-risk population.
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