Maternité Port-Royal, Université Paris Descartes, Groupe hospitalier Cochin Broca Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France.
DHU Risques et Grossesse, PRES Sorbonne Paris Cité, Paris, France.
PLoS One. 2019 Aug 1;14(8):e0220705. doi: 10.1371/journal.pone.0220705. eCollection 2019.
Although vaccination against influenza is recommended for pregnant women in France because it exposes them to a risk of death and severe respiratory complications, their vaccination coverage in 2016 was estimated at 7%. This study's principal objective was to assess the association between the availability of influenza vaccination at prenatal care visits and vaccination coverage.
This multicenter survey took place in 3 Paris-area public hospital (AP-HP) maternity wards (A, B, and C). Only maternity ward A offered the vaccine and vaccination without charge at prenatal visits. Data were collected from parturients during 10 days in January 2017 by a self-administered anonymous questionnaire.
Data from 248 women showed overall vaccination coverage of 19.4% (48/248): 35.4% (46/130) in maternity unit A, 2.7% (2/75) in B, and 0% (0/43) in C (P<0.01). After adjustment for socio-demographic characteristics, women at maternity ward A were significantly more likely to be vaccinated than those at B and C (aOR 25.52, 95%CI [5.76-113.10]). Other factors significantly associated with higher vaccination coverage were the mother's French birth (aOR 2.37 CI [1.03-5.46]) and previous influenza vaccination (aOR 3.13, 95%CI [1.25-7.86]). Vaccinated women generally considered they had received adequate information (aOR 4.15 CI [2.10-8.22]), principally from the professional providing their prenatal care. Nonvaccination was attributed to the absence of an offer of vaccination (81.5%), fear of fetal side effects (59.5%), and inadequate information (51.4%).
Our results show that availability of influenza vaccination, free of charge, at prenatal consultations at the maternity ward increases vaccination coverage significantly.
尽管法国建议孕妇接种流感疫苗，因为这会使她们面临死亡和严重呼吸道并发症的风险，但 2016 年她们的疫苗接种覆盖率估计为 7%。本研究的主要目的是评估产前保健就诊时流感疫苗的可及性与疫苗接种覆盖率之间的关联。
这项多中心调查在巴黎地区的 3 家公立医院（AP-HP）产科病房（A、B 和 C）进行。只有产科病房 A 在产前检查时提供免费疫苗接种。2017 年 1 月的 10 天内，通过自填匿名问卷收集了产妇的数据。
248 名女性的数据显示，总体疫苗接种覆盖率为 19.4%（48/248）：A 产科病房 35.4%（46/130），B 产科病房 2.7%（2/75），C 产科病房 0%（0/43）（P<0.01）。调整社会人口特征后，与 B 和 C 产科病房相比，A 产科病房的女性接种疫苗的可能性显著更高（调整后的优势比 25.52，95%置信区间[5.76-113.10]）。其他与更高疫苗接种覆盖率显著相关的因素包括母亲的法国出生（调整后的优势比 2.37，95%置信区间[1.03-5.46]）和既往流感疫苗接种（调整后的优势比 3.13，95%置信区间[1.25-7.86]）。接种疫苗的女性普遍认为她们接受了足够的信息（调整后的优势比 4.15，95%置信区间[2.10-8.22]），主要来自提供产前保健的专业人员。未接种疫苗归因于未提供疫苗接种（81.5%）、担心胎儿副作用（59.5%）和信息不足（51.4%）。
我们的结果表明，在产科病房的产前咨询中免费提供流感疫苗，可显著提高疫苗接种覆盖率。
