Predictors of Antenatal Seasonal Influenza Vaccination in an Underserved Population [15C]

Abstract

INTRODUCTION: Uptake of seasonal influenza vaccination among pregnant women remains low despite recommendations supporting routine vaccination in this population at high risk for severe morbidity. We evaluated predictors of antenatal influenza vaccination in an underserved patient population. METHODS: We conducted a retrospective cohort study of all women with deliveries to Emory healthcare providers at Grady Memorial Hospital, a large safety-net hospital, between July 1, 2016 and June 30, 2018. Demographic and clinical characteristics were abstracted from electronic medical records. The Kotelchuk Index was used to assess prenatal care adequacy. Adjusted relative risks (aRRs) and 95% confidence intervals (CIs) for associations between demographic and clinical characteristics and receipt of influenza vaccine were calculated using multivariable log-binomial models. IRB approval was obtained for this study. RESULTS: Among 3,727 women with deliveries, most were non-Hispanic black (68.60%) and had Medicaid as their primary insurer for delivery (87.93%). The overall vaccination rate was 49.80% (1,856/3,727). Characteristics significantly associated with influenza vaccination in multivariable models were Hispanic ethnicity (aRR 1.44, 95% CI 1.11-1.88), transferring care between institutions (aRR 0.34, 95% CI, 0.29-0.41), and inadequate prenatal care (aRR 0.70, 95% CI, 0.64-0.75). CONCLUSION: Women with inadequate or discontinuous prenatal care were less likely than women with adequate prenatal care to receive a seasonal influenza vaccine. Hispanic ethnicity was associated with increased rates of influenza vaccination, even after controlling for interpretive language services. These findings highlight the importance of continuous, regular prenatal care in recommending and offering antenatal vaccinations to pregnant patients while supporting possible cultural differences in vaccine acceptance.

Pertussis and influenza immunization: perceived attitude and decision of postpartum patients

“…Our survey of 200 postpartum participants who agreed to participate in an educational counseling session demonstrated that 38.2% who were previously unvaccinated during pregnancy, received Tdap vaccine prior to hospital discharge after receiving brief educational counseling, indicating that educational counseling can improve vaccination rates for Tdap in pregnancy beyond routine surveillance programs. Additionally, our study demonstrated that the most important factors influencing participants to receive Tdap and influenza vaccination was the desire to protect their baby, protect themselves and HCP recommendation, which are consistent with factors noted in other global studies [16][17][18]. Only half of our participants received Tdap vaccine and less than half received influenza vaccine prenatally, highlighting a gap in maternal vaccination coverage.…”