A recent study by the Norwegian Institute of Public Health found that vaccination rates against influenza and COVID-19 among pregnant women in Norway remain well below recommended targets. The research, led by Stecher et al. and published in Eurosurveillance, analyzed data from over 53,000 women who gave birth during the 2023/24 influenza season.
According to the study, only 29.9% of pregnant women received the influenza vaccine, while just 12.1% were vaccinated against COVID-19 during pregnancy. Both vaccines are recommended for pregnant women by the World Health Organization (WHO) and Norwegian health authorities due to increased risks for severe illness in this group. The WHO recommends a target vaccination rate of 75% for at-risk groups such as pregnant women.
Despite these recommendations, uptake remains low. The study found that only 11.4% of participants received both vaccines during pregnancy. For influenza, most vaccinations occurred in the second or third trimester, with coverage rising from 16.4% in October to a peak of 26.4% in November before leveling off. Vaccination rates were highest among women delivering in February (50.8%) but declined afterward.
COVID-19 vaccine uptake showed similar trends, with 10.1% receiving it during the later stages of pregnancy.
The researchers identified notable differences based on age and region: younger women (25 years or younger) had the lowest vaccination rates, while Oslo and Vestland counties reported higher coverage compared to Northern Norway.
Stecher et al. highlighted practical and psychological barriers as possible reasons for low uptake despite high trust in health authorities' recommendations within the population.
"These findings emphasise the need for more targeted strategies and better integration of vaccinations into routine pre-natal care for pregnant women in Norway, along with comprehensive surveillance of maternal vaccination," said the authors.
In Norway, access to these vaccines differs: while the COVID-19 vaccine is available year-round and free of charge, the influenza vaccine is offered only during flu season and requires payment from patients.
The authors suggested removing financial barriers and improving accessibility as ways to address hesitancy toward vaccination among pregnant women. They also noted international evidence indicating that integrating free vaccines into routine prenatal care can improve coverage; for example, uptake of whooping cough vaccine increased after its inclusion in Norway's maternal immunization program.
Similar issues with low coverage have been observed globally due to limited surveillance systems and inconsistent integration into prenatal care programs. The authors concluded that coordinated efforts are needed across Europe and worldwide to promote maternal immunization.
