Boattini Matteo, Bianco Gabriele, Charrier Lorena, Iannaccone Marco, Masuelli Giulia, Coggiola Maurizio, Sacchi Alessandra, Pittaluga Fabrizia, Cavallo Rossana
Microbiology and Virology Unit, University Hospital Città della Salute e della Scienza di Torino, Turin, Italy.
Department of Public Health and Paediatrics, University of Torino, Turin, Italy.
Prev Med Rep. 2019 Jul 4;15:100945. doi: 10.1016/j.pmedr.2019.100945. eCollection 2019 Sep.
Voluntary termination of pregnancy (VTP), pre-conception and post-partum phases, as well as Occupational Medicine consultation for healthcare workers are opportunities for screening and vaccinating rubella seronegative childbearing women. However, data about vaccination acceptance following these phases is rarely reported. A retrospective study over a 2-year period (2016-2017) was performed, evaluating the prevalence of rubella seronegative women which underwent VTP (wVTP), mothers in early puerperal phase (mEPP) and childbearing healthcare workers (CbHW) aged 15-49 years. Anti-rubella vaccination rates and factors associated with vaccine hesitancy (VH) were investigated. Anti-rubella IgG titres were assessed in 8623 women. Seroprevalence of rubella susceptibility was 7.9% (wVTP 6.4%; mEPP 17.4%; CbHW 9.3%). Anti-rubella vaccination rates were found to be different in the three groups (wVTP 37.1%; mEPP 10.9%; CbHW 25.4%), specifically in 2016 and among women born in Italy. VH rate was higher in 2017, especially among wVTP and CbHW. Anti-rubella vaccination rates in wVTP mEPP was higher in women born in Italy but not in those born abroad. Multivariable analyses demonstrated significantly higher risk of VH for mEPP (OR 8.2; 95% CI: 3.9-16.9) and women reporting history of allergy to drugs, food or environmental agents (OR 2.7; 95% CI: 1.4-5.1). During the analyzed period childbearing women included in this study were not adequately protected against rubella. Anti-rubella vaccination rates were widely unsatisfactory. Being mEPP and reporting allergy were significantly associated to higher rates of VH. Tailored strategies targeting on vaccine safety are needed for retention of these women in immunisation programmes.
人工终止妊娠、孕前和产后阶段，以及为医护人员提供职业医学咨询，都是对风疹血清学阴性的育龄妇女进行筛查和接种疫苗的机会。然而，关于这些阶段后疫苗接种接受情况的数据很少被报道。我们进行了一项为期2年（2016 - 2017年）的回顾性研究，评估了接受人工终止妊娠的风疹血清学阴性妇女（wVTP）、产后早期母亲（mEPP）以及年龄在15 - 49岁的育龄医护人员（CbHW）的患病率。研究了抗风疹疫苗接种率以及与疫苗犹豫（VH）相关的因素。对8623名妇女进行了抗风疹IgG滴度评估。风疹易感性的血清阳性率为7.9%（wVTP为6.4%；mEPP为17.4%；CbHW为9.3%）。发现三组的抗风疹疫苗接种率不同（wVTP为37.1%；mEPP为10.9%；CbHW为25.4%），特别是在2016年以及意大利出生的女性中。VH率在2017年更高，尤其是在wVTP和CbHW中。意大利出生的wVTP和mEPP中的抗风疹疫苗接种率较高，但国外出生的女性并非如此。多变量分析表明，mEPP（OR 8.2；95% CI：3.9 - 16.9）以及报告有药物、食物或环境因素过敏史的女性（OR 2.7；95% CI：1.4 - 5.1）的VH风险显著更高。在分析期间，本研究纳入的育龄妇女未得到充分的风疹防护。抗风疹疫苗接种率普遍不尽人意。处于mEPP状态以及报告有过敏史与较高的VH率显著相关。需要针对疫苗安全性制定针对性策略，以使这些妇女继续参与免疫计划。
