Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, Auckland, New Zealand.
School of Health Sciences, University of Canterbury, Christchurch, Canterbury, New Zealand; Immunisation Advisory Centre, University of Auckland, Auckland, New Zealand; Department of Paediatrics: Child and Youth Health, University of Auckland, New Zealand.
Vaccine. 2022 Mar 25;40(14):2150-2160. doi: 10.1016/j.vaccine.2022.02.079. Epub 2022 Mar 2.
Adequate maternal vaccination coverage is critical for the prevention and control of infectious disease outbreaks such as pertussis, influenza, and more recently COVID-19. To guide efforts to increase vaccination coverage this study examined the extent of vaccination coverage in pregnant New Zealand women over time by area-level deprivation and ethnicity.
A retrospective cohort study was used consisting of all pregnant women who delivered between 01 January 2013 and 31 December 2018, using administrative health datasets. Outcomes were defined as receipt of influenza or pertussis vaccination in any one of the relevant data sources (National Immunisation Register, Proclaims, or Pharmaceutical collection) during their eligible pregnancy. Ethnicity was prioritised as Māori (NZ indigenous), Pacific, Asian, and Other or NZ European and deprivation was defined using New Zealand Index of Multiple Deprivation (IMD).
Between 2013 and 2018, Asian women had the highest maternal vaccination coverage (36%) for pertussis, while Māori and Pacific women had the lowest, 13% and 15% respectively. Coverage of pertussis vaccination during pregnancy in low deprivation Māori women was 24% and 28% in Pacific women. This is in comparison to 30% and 25% in high deprivation Asian and European/Other women, respectively. Similar trends were seen for influenza.
Between 2013 and 2018 maternal vaccination coverage increased for pertussis and influenza. Despite this coverage remains suboptimal, and existing ethnic and deprivation inequities increased. There is an urgent need to focus on equity, to engage and support ethic communities by creating genuinely accessible, culturally appropriate health services.
足够的孕产妇疫苗接种覆盖率对于预防和控制百日咳、流感等传染病的爆发至关重要，最近对于 COVID-19 也是如此。为了指导增加疫苗接种覆盖率的工作，本研究通过地区贫困程度和种族来考察新西兰孕妇在一段时间内的疫苗接种覆盖率。
本研究采用回顾性队列研究，纳入了 2013 年 1 月 1 日至 2018 年 12 月 31 日期间分娩的所有孕妇，使用行政健康数据集。结果定义为在其符合条件的妊娠期间在任何一个相关数据源（国家免疫登记册、Proclaims 或药物收集）中接受流感或百日咳疫苗接种。种族优先考虑新西兰土著毛利人、太平洋岛民、亚洲人和其他或新西兰欧洲人，贫困程度用新西兰多重贫困指数（IMD）来定义。
在 2013 年至 2018 年间，亚洲妇女的百日咳疫苗接种覆盖率最高（36%），而毛利人和太平洋岛民妇女的覆盖率最低，分别为 13%和 15%。低贫困毛利妇女在怀孕期间接种百日咳疫苗的覆盖率为 24%，而太平洋妇女的覆盖率为 28%。相比之下，高贫困的亚洲和欧洲/其他妇女的覆盖率分别为 30%和 25%。流感疫苗的接种情况也存在类似的趋势。
在 2013 年至 2018 年期间，百日咳和流感疫苗的接种覆盖率有所增加。尽管如此，接种覆盖率仍然不理想，而且现有的种族和贫困不平等现象加剧了。迫切需要关注公平问题，通过创建真正可及、文化上合适的卫生服务，与种族社区接触并支持他们。
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