Irving Stephanie A, Ball Sarah W, Booth Stephanie M, Regan Annette K, Naleway Allison L, Buchan Sarah A, Katz Mark A, Effler Paul V, Svenson Lawrence W, Kwong Jeffrey C, Feldman Becca S, Klein Nicola P, Chung Hannah, Simmonds Kimberley
Kaiser Permanente Center for Health Research, Portland OR, USA.
Abt Associates, Cambridge MA, USA; Westat, Rockville, MD, USA.
Vaccine. 2021 Dec 20;39(52):7598-7605. doi: 10.1016/j.vaccine.2021.11.018. Epub 2021 Nov 19.
Many countries recommend influenza vaccination during pregnancy. Despite this recommendation, influenza vaccine among pregnant individuals remains under-utilized and uptake varies by country. Factors associated with influenza vaccine uptake during pregnancy may also vary across countries.
As members of the Pregnancy Influenza Vaccine Effectiveness Network (PREVENT), five sites from four countries (Australia, Canada, Israel, and the United States) retrospectively identified cohorts of individuals aged 18-50 years who were pregnant during pre-defined influenza seasons. Influenza vaccine coverage estimates were calculated for the 2010-11 through 2015-16 northern hemisphere and the 2012 through 2015 southern hemisphere influenza seasons, by site. Sites used electronic health records, administrative data, and immunization registries to collect information on pregnancy, health history, demographics, and vaccination status. Each season, vaccination coverage was calculated as the percentage of individuals who received influenza vaccine among the individuals in the cohort that season. Characteristics were compared between those vaccinated and unvaccinated, by site.
More than two million pregnancies were identified over the study period. Influenza vaccination coverage ranged from 5% to 58% across sites and seasons. Coverage increased consistently over the study period at three of the five sites (Western Australia, Alberta, and Israel), and was highest in all seasons at the United States study site (39-58%). Associations with vaccination varied by country and across seasons; where available, parity >0, presence of a high-risk medical condition, and urban residence were consistently associated with increased likelihood of vaccination.
Though increasing, uptake of influenza vaccine among pregnant individuals remains lower than recommended. Coverage varied substantially by country, suggesting an ongoing need for targeted strategies to improve influenza vaccine uptake in this population.
许多国家建议在孕期接种流感疫苗。尽管有此建议，但孕妇群体中流感疫苗的使用率仍然较低，且各国的接种率有所不同。孕期流感疫苗接种率相关因素在不同国家也可能存在差异。
作为孕期流感疫苗有效性网络（PREVENT）的成员，来自四个国家（澳大利亚、加拿大、以色列和美国）的五个研究点回顾性确定了在预先定义的流感季节期间怀孕的18至50岁个体队列。按研究点计算了2010 - 11年至2015 - 16年北半球以及2012年至2015年南半球流感季节的流感疫苗接种覆盖率。研究点使用电子健康记录、行政数据和免疫登记系统收集有关怀孕、健康史、人口统计学和疫苗接种状况的信息。每个季节，接种覆盖率计算为该季节队列中接种流感疫苗的个体占比。按研究点比较接种者和未接种者的特征。
在研究期间共识别出超过200万例妊娠。各研究点和各季节的流感疫苗接种覆盖率在5%至58%之间。在五个研究点中的三个（西澳大利亚、艾伯塔和以色列），接种覆盖率在研究期间持续上升，且在美国研究点所有季节的接种率最高（39% - 58%）。与疫苗接种的关联因国家和季节而异；在可得数据的情况下，多胎妊娠>0、存在高危医疗状况和城市居住情况始终与接种可能性增加相关。
尽管有所上升，但孕妇群体中流感疫苗的接种率仍低于建议水平。各国的接种覆盖率差异很大，表明持续需要有针对性的策略来提高该人群的流感疫苗接种率。
