Coverage with Tetanus, Diphtheria, and Acellular Pertussis Vaccine and Influenza Vaccine Among Pregnant Women — Minnesota, March 2013–December 2014

Barber, A.; Muscoplat, Miriam Halstead; Fedorowicz, Anna

doi:10.15585/mmwr.mm6602a4

Cited by 33 publications

(31 citation statements)

References 6 publications

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“…The overall vaccination rate in our study (48.9%) is similar to that reported by the CDC in national data for the 2016-17 and 2017-18 seasons, which was approximately 50% [9,14]. Our finding of inadequate prenatal care being associated with decreased likelihood of influenza vaccination is consistent with results from state-and national-level Pregnancy Risk Assessment Monitoring System studies [15,16]. Our findings of similar vaccination rates for intermediate, adequate, and adequate plus prenatal care suggest a threshold effect of increasing prenatal care in relation to influenza vaccine uptake in our study population.…”

Section: Discussionsupporting

confidence: 90%

“…Our findings of similar vaccination rates for intermediate, adequate, and adequate plus prenatal care suggest a threshold effect of increasing prenatal care in relation to influenza vaccine uptake in our study population. This is a novel finding compared to similar studies which have noted a dose-dependent relationship between prenatal care adequacy and influenza vaccine coverage [15,16]. Given the high percentage of women in our population that received less than adequate prenatal care, we speculate that providers in this setting may recognize the limited opportunities for vaccination and prioritize influenza vaccine counseling during all prenatal care visits.…”

Section: Discussionsupporting

confidence: 50%

See 1 more Smart Citation

Factors Associated with Antenatal Influenza Vaccination in a Medically Underserved Population

Adams

Biswas

Boulet

et al. 2020

Infectious Diseases in Obstetrics and Gynecology

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Influenza infection in pregnant women is associated with increased risk of morbidity and mortality. Despite recommendations for all women to receive the seasonal influenza vaccine during pregnancy, vaccination rates among pregnant women in the U.S. have remained around 50%. The objective of this study was to evaluate clinical and demographic factors associated with antenatal influenza vaccination in a medically underserved population of women. We conducted a retrospective cohort study at Grady Memorial Hospital, a large safety-net hospital in Atlanta, Georgia, from July 1, 2016, to June 30, 2018. Demographic and clinical characteristics were abstracted from the electronic medical record. The Kotelchuck index was used to assess prenatal care adequacy. Relative risks and 95% confidence intervals for associations between receipt of influenza vaccine and prenatal care adequacy, demographic characteristics, and clinical characteristics were calculated using multivariable log-binominal models. Among 3723 pregnant women with deliveries, women were primarily non-Hispanic black (68.4%) and had Medicaid as their primary insurance type (87.9%). The overall vaccination rate was 49.8% (1853/3723). Inadequate prenatal care adequacy was associated with a lower antenatal influenza vaccination rate (43.5%), while intermediate and higher levels of prenatal care adequacy were associated with higher vaccination rates (66.9–68.3%). Hispanic ethnicity, non-Hispanic other race/ethnicity, interpreter use for a language other than Spanish, and preexisting diabetes mellitus were associated with higher vaccination coverage in multivariable analyses. Among medically underserved pregnant women, inadequate prenatal care utilization was associated with a lower rate of antenatal influenza vaccination. Socially disadvantaged women may face individual and structural barriers when accessing prenatal care, suggesting that evidenced-based, tailored approaches may be needed to improve prenatal care utilization and antenatal influenza vaccination rates.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 50%

Factors Associated with Antenatal Influenza Vaccination in a Medically Underserved Population

Adams

Biswas

Boulet

et al. 2020

Infectious Diseases in Obstetrics and Gynecology

View full text Add to dashboard Cite

show abstract

“…Comparable rates of influenza vaccine uptake were seen among pregnant women in Alberta in 2014-2015 with a 14.58% rate of uptake compared to 62.39% uptake among seniors and 34.9% uptake for children aged 6-23 months 5 . In contrast, populationbased estimates from other developed countries suggest uptake rates of 26% in England 6 and as high as 40-50% in Australia, 7,8 Ireland 9 and the United States 10 .…”

Section: Introductionmentioning

confidence: 87%

A Systematic Review of Barriers to Vaccination During Pregnancy in the Canadian Context

Poliquin

Greyson

Castillo

2019

Journal of Obstetrics and Gynaecology Canada

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Objective: While vaccination in pregnancy has the potential to dramatically impact maternal and infant morbidity and mortality, uptake of recommended vaccinations in pregnancy remains low. Our objective was to identify barriers and facilitators of vaccination during pregnancy in Canada. Methods: The MEDLINE database, as well as the table of contents of four relevant Canadian journals were screened to identify all studies that considered barriers and/or facilitators to vaccination during pregnancy, specifically in Canadian settings. Citations were screened and a narrative synthesis of findings was undertaken given the heterogeneity of study design. Results: In total, 17 studies met inclusion criteria, most with a focus on the seasonal and pandemic influenza vaccines. Facilitators and barriers were identified at the level of the patient and the provider. At both levels, knowledge was an important facilitator of vaccine acceptance during pregnancy and was notably improved in studies following the 2009 pandemic H1N1 influenza compared to earlier studies. Vaccine endorsement by a prenatal care provider and clear messages of safety for the fetus emerged as key motivators. Few studies addressed system level barriers or interventions for improving vaccine uptake during pregnancy in the Canadian setting. Conclusions: Common themes have emerged from the Canadian literature addressing barriers and facilitators of vaccination during pregnancy. However, there is a paucity of literature to suggest strategies to improve the uptake of vaccination during pregnancy in Canadian settings. Further research is urgently needed given the expanding role of vaccination during routine prenatal care.

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“…In this study, we observed a high proportion of correct vaccination among pertussis cases (90.0%), compared to a study conducted in Minnesota which showed a lower VC with dTap (58.2%) [27]. Nonetheless, these studies are essential for identifying other relevant socio-demographic variables, which we did not include in our analysis (e.g.…”

Section: Discussionmentioning

confidence: 54%

Proper pertussis vaccination will probably not increase vaccination coverage: a case–control study

Solano

et al. 2019

Epidemiol. Infect.

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Vaccination coverage (VC) against pertussis can increase when management practices and policies at primary care centres (PCCs) are reinforced. From 2011 to 2015, we performed a case–control study to evaluate VC among pertussis patients treated at PCCs in Barcelona, Spain. We recorded pertussis in patients from 8- to 16-year-olds at 52 PCCs. Pertussis cases had laboratory diagnostic and controls were healthy outpatients visiting the same facility for reasons other than cough. DTaP/dTap VC was recorded as either proper vaccination status (five doses recorded) or improper vaccination status (<5 doses recorded). We used a logistic regression model to estimate OR and 95% CI. We included 229 cases and 576 controls. VC was higher in cases (mean 5.01, s.e.: 0.57) than in controls (4.89, s.e.: 0.73). Around 69% of the cases had received DTaP primary immunisation after 2–5 years and 31.4% of cases had the dTap booster immunisation after 7–10 years. The 87% of children 5–9 years were properly vaccinated. We found no protection from becoming ill among properly vaccinated children (OR 1.87; 95% CI 1.22–2.85). The highest VC was observed in patients with confirmed pertussis, which was likely due to a more exhaustive follow-up of the VC in these patients. Being properly vaccinated against pertussis will probably not increase VC.

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Coverage with Tetanus, Diphtheria, and Acellular Pertussis Vaccine and Influenza Vaccine Among Pregnant Women — Minnesota, March 2013–December 2014

Cited by 33 publications

References 6 publications

Factors Associated with Antenatal Influenza Vaccination in a Medically Underserved Population

Factors Associated with Antenatal Influenza Vaccination in a Medically Underserved Population

A Systematic Review of Barriers to Vaccination During Pregnancy in the Canadian Context

Proper pertussis vaccination will probably not increase vaccination coverage: a case–control study

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