Cambou Mary Catherine, Copeland Timothy P, Nielsen-Saines Karin, Macinko James
UCLA David Geffen School of Medicine, Division of Infectious Diseases, 10833 Le Conte Ave, CHS 37-121, Los Angeles, CA 90095, United States; UCLA Fielding School of Public Health, Department of Health Policy and Management, 650 Charles E Young Drive, CHS 31-235B, United States.
UCLA Fielding School of Public Health, Department of Health Policy and Management, 650 Charles E Young Drive, CHS 31-235B, United States.
Vaccine. 2021 Apr 8;39(15):2068-2073. doi: 10.1016/j.vaccine.2021.03.026. Epub 2021 Mar 18.
While the influenza vaccine is recommended for all pregnant women, influenza vaccine coverage among this high-risk population remains inadequate. Factors associated with vaccine coverage among pregnant women, including insurance status, are poorly understood. In a cross-sectional study of the National Health Interview Survey (NHIS) data from 2012 to 2018, we evaluated predictors of self-reported influenza vaccine coverage in pregnant women. Among 1,942 pregnant women surveyed, 39% reported receiving the influenza vaccine in accordance with national recommendations. Influenza vaccine coverage increased by 8 percentage points from 2012 to 2018. Only 15% of uninsured pregnant women received the influenza vaccine, compared to 41% of those with insurance (design-corrected F-test, p-value < 0.001). In the multivariate Poisson regression analysis, significant predictors of influenza vaccine coverage were health insurance (prevalence ratio [PR] 1.90, 95% confidence interval [CI] 1.23-2.93), ratio of household income to federal poverty level (FPL) threshold greater than 400% (PR 1.54, 95% CI 1.20-1.96), graduate school education (PR 1.52, 95% CI 1.04-2.23), and the 2015-2018 survey year period (PR 1.27, 95% CI 1.08-1.49). While previous literature focuses heavily on demographics, our research underscores the need to further explore modifiable factors that impact vaccine uptake during pregnancy, particularly the interplay between health insurance and access to care.
虽然建议所有孕妇接种流感疫苗，但这一高危人群的流感疫苗接种率仍然不足。包括保险状况在内的与孕妇疫苗接种率相关的因素尚不清楚。在一项对2012年至2018年美国国家健康访谈调查（NHIS）数据的横断面研究中，我们评估了孕妇自我报告的流感疫苗接种率的预测因素。在接受调查的1942名孕妇中，39%报告按照国家建议接种了流感疫苗。从2012年到2018年，流感疫苗接种率提高了8个百分点。只有15%的未参保孕妇接种了流感疫苗，而参保孕妇的这一比例为41%（设计校正F检验，p值<0.001）。在多变量泊松回归分析中，流感疫苗接种率的显著预测因素包括医疗保险（患病率比值[PR]1.90，95%置信区间[CI]1.23-2.93）、家庭收入与联邦贫困线（FPL）阈值之比大于400%（PR 1.54，95%CI 1.20-1.96）、研究生学历（PR 1.52，95%CI 1.04-2.23）以及2015-2018年调查年份（PR 1.27, 95%CI 1.08-1.49）。虽然以往的文献主要关注人口统计学因素，但我们的研究强调需要进一步探索影响孕期疫苗接种的可改变因素，特别是医疗保险与获得医疗服务之间的相互作用。
