INSERM, UMRS 953, Epidemiological Research Unit on Perinatal and Women's and Children's Health, Paris, France.
Vaccine. 2012 Aug 17;30(38):5661-5. doi: 10.1016/j.vaccine.2012.06.077. Epub 2012 Jul 7.
Pregnant women were a priority group for vaccination during the 2009 A(H1N1) influenza pandemic. In France, vaccination was organized in ad hoc centers. Women received vouchers by mail and were given a non-adjuvanted vaccine. Our objective was to assess the national vaccination rate among pregnant women and to determine the association of vaccination with maternal characteristics, prenatal care, and pregnancy-related health behaviors.
Data came from a national representative sample of women who gave birth in March 2010 (N=13 453) and were interviewed in the hospital before discharge; they were in the second trimester of pregnancy during the vaccination campaign. Associations between vaccination and socio-demographic and medical characteristics, region of residence, care providers, and preventive behaviors were assessed with bivariable analyses and logistic regression models.
Vaccine coverage was 29.3% (95% CI: 28.6-30.1). The main reason for not being vaccinated was that women did not want this immunization (91%). In adjusted analyses, vaccination was more frequent in women who were older, employed, born in France, with a parity of 1 or 2 and specific favourable health behaviors. The adjusted odds ratio for women with a postgraduate educational level was 4.1 (95% CI: 3.5-4.8) compared to those who did not complete high school. Women with additional risk factors for complications from A(H1N1) infection had a vaccination rate similar to that of other women.
The vaccination campaign resulted in poor vaccination coverage, strong social inequalities, and no special protection for pregnant women at the highest risk of complications. These findings provide essential information for the organization of future vaccination campaigns.
在 2009 年甲型 H1N1 流感大流行期间，孕妇是疫苗接种的重点人群。在法国，疫苗接种是在专门的中心进行的。孕妇通过邮件收到凭证，并接种了无佐剂疫苗。我们的目的是评估孕妇的全国疫苗接种率，并确定接种与产妇特征、产前保健和与妊娠相关的健康行为之间的关联。
数据来自于 2010 年 3 月分娩的具有代表性的全国性孕妇样本（N=13453），在出院前在医院接受了访谈；她们在疫苗接种活动期间处于妊娠中期。使用单变量分析和逻辑回归模型评估了接种疫苗与社会人口统计学和医学特征、居住地、医疗服务提供者和预防行为之间的关联。
疫苗覆盖率为 29.3%（95%置信区间：28.6-30.1）。未接种疫苗的主要原因是女性不想接受这种免疫接种（91%）。在调整后的分析中，疫苗接种在年龄较大、有工作、出生在法国、产次为 1 或 2 次以及具有特定有利健康行为的女性中更为常见。与未完成高中学业的女性相比，具有研究生学历的女性接种疫苗的调整后优势比为 4.1（95%置信区间：3.5-4.8）。具有甲型 H1N1 感染并发症额外风险因素的女性与其他女性的接种率相似。
疫苗接种运动导致接种率低、社会不平等严重，且高危孕妇未得到特殊保护。这些发现为未来的疫苗接种运动提供了重要信息。
