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Routine Maternal Vaccine Uptake during the COVID-19 Pandemic
Savannah Cotter1, Lauren Taylor1, Rebecca Grace2
1Michael E. Debakey Department of Surgery, Baylor College of Medicine, Houston, Texas.
Insights
COVID-19 pandemic significantly reduced influenza and Tdap vaccine uptake in pregnant, low-income women. Influenza vaccine rates saw a steeper decline, particularly among non-Hispanic Black patients.
Area of Science:
- Public Health
- Epidemiology
- Maternal Health
Background:
- The COVID-19 pandemic presented unprecedented challenges to healthcare access and delivery.
- Routine vaccination is crucial for maternal and infant health, including influenza and Tdap vaccines.
- Understanding pandemic-related impacts on vaccination is vital for public health strategies.
Purpose of the Study:
- To assess the effect of the COVID-19 pandemic on influenza and Tdap vaccine uptake among pregnant women in a low-income population.
- To compare vaccination rates before and during the pandemic.
- To identify demographic factors associated with vaccine uptake during the pandemic.
Main Methods:
- Retrospective cohort study of 939 pregnant women attending Medicaid clinics.
- Comparison of vaccination rates between a prepandemic group (May-Nov 2019) and a pandemic group (May-Nov 2020).
- Multivariate logistic regression analysis to evaluate vaccination trends and demographic associations.
Main Results:
- Overall influenza vaccine uptake decreased from 78% to 61% (p<0.01).
- Overall Tdap vaccine uptake decreased from 85% to 76% (p<0.01).
- Influenza vaccine uptake saw a significant decrease in non-Hispanic Black patients (64% to 35%, p<0.01).
Conclusions:
- The COVID-19 pandemic led to a significant reduction in routine influenza and Tdap vaccination among pregnant women in this low-income cohort.
- The decline in influenza vaccination was more pronounced than for Tdap vaccine.
- Non-Hispanic Black pregnant women experienced the most substantial decrease in influenza vaccine uptake during the pandemic.
Objective:
This study examines the impact of the coronavirus disease 2019 (COVID-19) pandemic on influenza and tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine uptake in a pregnant, low-income population.
Study Design:
This retrospective cohort study included women initiating prenatal care before (May-November 2019) or during the COVID-19 pandemic (May-November 2020) at two large Medicaid clinics. All patients entered prenatal care before 20 weeks and delivered full-term. Medical records were reviewed for vaccine uptake and demographic data. Multivariate logistic regression analysis was used to compare vaccination rates prior to and during the COVID-19 pandemic. Additional analysis was performed to identify association of demographic factors with vaccine uptake. IRB approval was obtained for this study.
Results:
A total of 939 patients met inclusion criteria, with 462 initiating care prior to and 477 initiating care during the COVID-19 pandemic. Influenza vaccination uptake was 78% (362/462) in the prepandemic group, significantly decreasing to 61% (291/477) in the pandemic group (p <0.01, odds ratio [OR] = 0.38, confidence interval [CI]: 0.26-0.53). Tdap vaccination uptake was 85% (392/462) in the prepandemic group, significantly decreasing to 76% (361/477) in the pandemic group (p <0.01, OR = 0.56, CI: 0.40-0.79). The decrease in influenza vaccine uptake was most significant in non-Hispanic Black patients, decreasing from 64% (73/114) in the prepandemic group to 35% (35/101) in the pandemic group (p <0.01, OR = 0.30, CI: 0.17-0.52), while there was no significant difference in age or parity in relation to vaccination status.
Conclusion:
Routine vaccination uptake significantly decreased during the COVID-19 pandemic in a low-income population of pregnant women, with decrease more pronounced on influenza vaccine than on Tdap vaccine uptake, especially in non-Hispanic Black patients.
Key Points:
· Influenza and Tdap vaccination uptake during pregnancy has decreased during the COVID-19 pandemic.. · Influenza vaccine uptake decreased more than Tdap in pregnancy during the COVID-19 pandemic.. · The greatest decrease was seen in influenza vaccine uptake in non-Hispanic Black patients..
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