1School of Pharmacy, National Taiwan University, Taipei, Taiwan.
2Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.
J Womens Health (Larchmt). 2019 Jul;28(7):965-975. doi: 10.1089/jwh.2018.7139. Epub 2019 Jan 14.
The issue of suboptimal influenza vaccination coverage among pregnant women remains relevant. Our study aimed to explore the determinants and coverage of influenza vaccination among pregnant women in the United States using a nationally representative sample. This study was conducted with the 2012-2016 U.S. National Health Interview Survey. The Andersen's Health Behavior Model was applied as the conceptual framework to explore potential factors that may influence the influenza vaccination rate. A series of individual determinants, categorized into predisposing, enabling, and need factors, were compared using logistic regressions between women who received an influenza vaccination before or during pregnancy and those who did not. An average of 36% women received an influenza vaccination before or during pregnancy among an estimated five million pregnant women. Even though the percentage increased from 31% in 2012 to 40% in 2016, it remained lower than the Healthy People 2020 target of 80%. The odds of receiving an influenza vaccination before or during pregnancy were lower among women who had public or no insurance coverage (odds ratio [OR]; 95% confidence interval, 0.510 [0.323-0.806] and 0.351 [0.175-0.705], respectively), lived in South (0.546 [0.336-0.887]), ever smoked 100 cigarettes (0.622 [0.419-0.923]), and had infrequent to light alcohol consumption in the past year (0.670 [0.457-0.983], reference: no alcohol consumption in the past year). Having a bachelor's degree increased the odds of getting an influenza vaccine compared to a high school diploma or less (2.086 [1.353-3.215]). Our study found that the influenza vaccination coverage among pregnant women remains suboptimal, and disparities may still exist across women with different sociodemographic and socioeconomic status. Clinicians should actively recommend influenza vaccination for pregnant women, and policy makers may consider developing interventions to improve the vaccination rate.
孕妇人群中流感疫苗接种覆盖率不足仍是一个问题。本研究旨在使用具有全国代表性的样本，探索美国孕妇流感疫苗接种的决定因素和覆盖率。本研究采用了 2012-2016 年美国国家健康访谈调查数据。本研究应用安德森健康行为模型作为概念框架，探索可能影响流感疫苗接种率的潜在因素。通过逻辑回归，将在孕期前或孕期内接种过流感疫苗的女性与未接种过的女性进行比较，比较了一组分为倾向因素、促成因素和需求因素的个体决定因素。在估计的五百万名孕妇中，有 36%的孕妇在孕期前或孕期内接种了流感疫苗。尽管这一比例从 2012 年的 31%上升到 2016 年的 40%，但仍低于 2020 年健康人 80%的目标。在有公共保险或没有保险的女性中（比值比 [OR]；95%置信区间，0.510 [0.323-0.806] 和 0.351 [0.175-0.705]），在南方（0.546 [0.336-0.887]）居住，曾经吸烟 100 支（0.622 [0.419-0.923]），且在过去一年中饮酒频率较低或轻度饮酒（0.670 [0.457-0.983]）的女性中，在孕期前或孕期内接种流感疫苗的几率较低（参考：过去一年中无饮酒）。与高中或以下学历相比，拥有学士学位的女性接种流感疫苗的几率更高（2.086 [1.353-3.215]）。我们的研究发现，孕妇的流感疫苗接种覆盖率仍然不足，不同社会人口和经济地位的女性之间可能仍然存在差异。临床医生应积极向孕妇推荐流感疫苗接种，政策制定者可能需要考虑制定干预措施来提高疫苗接种率。
