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Published on: May 21, 2015
Acceptance of Routine Vaccines in Pregnancy during the COVID-19 Pandemic
Allison D Perelman1, Megan E Trostle2, Jillian Pecoriello1
1Department of Obstetrics & Gynecology, NYU Langone Health, New York, New York.
Insights
Pregnant individuals were more likely to receive the influenza vaccine during the COVID-19 pandemic, but Tetanus, Diphtheria, and Pertussis (Tdap) vaccine rates remained unchanged. High-risk groups, including those with public insurance or medical comorbidities, saw decreased vaccination uptake.
Area of Science:
- Obstetrics and Gynecology
- Infectious Disease Epidemiology
- Public Health
Background:
- The COVID-19 pandemic presented challenges to routine healthcare, potentially impacting vaccination rates in pregnant individuals.
- Understanding vaccination trends during this period is crucial for maternal and infant health.
- Assessing vaccine uptake for Tetanus, Diphtheria, and Pertussis (Tdap) and influenza is vital for preventing infectious diseases in pregnancy.
Purpose of the Study:
- To compare antenatal Tdap and influenza vaccination rates during the COVID-19 pandemic with historical controls.
- To identify demographic and clinical factors associated with vaccination acceptance during the pandemic.
- To evaluate potential disparities in vaccine uptake among pregnant populations.
Main Methods:
- A retrospective cohort study design was employed, comparing pregnant individuals from September 2020 to January 2021 with a historical cohort from the prior year.
- Data included demographics, prenatal care initiation, insurance status, and medical comorbidities.
- Statistical analyses included chi-square tests, Fisher's exact test, and multivariable logistic regression (p < 0.05).
Main Results:
- Overall, pregnant individuals were more likely to receive the influenza vaccine during the pandemic (aOR 1.7).
- Tdap vaccine acceptance rates were similar between the pandemic and control groups (aOR 1.5).
- However, pregnant individuals with public insurance and medical comorbidities showed significantly decreased rates for both influenza and Tdap vaccines during the pandemic.
Conclusions:
- While overall influenza vaccination increased during the COVID-19 pandemic, Tdap vaccination rates did not change.
- Significant disparities in vaccine uptake were observed in high-risk populations, including those with public insurance and comorbidities.
- These findings underscore the need for targeted vaccination counseling and interventions to address inequities in maternal immunization.
Objective:
This study aimed to evaluate the rates of vaccination against infectious diseases (Tetanus, Diphtheria, and Pertussis [Tdap] and influenza) in pregnancy during the coronavirus disease 2019 (COVID-19) pandemic compared to contemporary historical controls.
Study Design:
This was a retrospective cohort study comparing rates of Tdap and influenza vaccination in pregnant people who received care at NYU Langone Health and delivered from September 1, 2020, to January 31, 2021 ("COVID cohort") to the same period the prior year ("2019 cohort"). Demographic information, trimester of initiation of prenatal care, insurance status, and medical comorbidities were evaluated. Outcomes were analyzed using chi-square, Fisher's exact test, and multivariable logistic regression, with significance of p < 0.05.
Results:
In total, 1,713 pregnant people were included. Compared to historical controls, the COVID cohort differed in age, race, timing of initiation of prenatal care, insurance status, and medical comorbidities. After adjusting for these covariates, pregnant people were significantly more likely to accept influenza vaccine in the COVID cohort (adjusted odds ratio [aOR] 1.7, 95% confidence interval [CI] 1.27-2.29) and had similar Tdap acceptance (aOR 1.5, 95% CI 0.99-2.17). However, this trend was not observed for the entire obstetric population; public insurance status and medical comorbidities were associated with lower vaccine rates during the pandemic. For those who had public insurance, rates of influenza vaccination decreased from 83% in 2019 to 40% during COVID (aOR 0.16, 95% CI 0.10-0.24) and for Tdap rates decreased from 93 to 54% (aOR 0.13, 95% CI 0.08-0.21).
Conclusion:
During the COVID-19 pandemic era, pregnant people at large were more likely to accept the influenza vaccine. However, this trend did not apply to Tdap, and high-risk groups with public insurance and medical comorbidities. This study highlights potential disparities in vaccination rates, which need to be accounted for when evaluating national vaccine trends. These data support increased efforts in vaccine counseling for high-risk populations.
Key Points:
· Antenatal flu vaccination increased during the pandemic.. · Antenatal Tdap vaccination was unchanged during the pandemic.. · High-risk pregnant patients had decreased vaccine uptake.. · High-risk subgroups were not included in overarching vaccination trends..
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