Department of General Practice, Faculty of Medicine, University Clermont Auvergne, 28 Place Henri Dunant, 63001, Clermont-Ferrand, France.
Biostatistics Unit (Clinical Research and Innovation Department), University Hospital Clermont-Ferrand, Clermont-Ferrand, France.
Sci Rep. 2022 May 3;12(1):7153. doi: 10.1038/s41598-022-11308-3.
Pregnant women have a high risk of severe influenza, associated with obstetrical complications. The World Health Organization (WHO) has recommended influenza vaccination for all pregnant women since 2012. The vaccination coverage remains low worldwide, and in Europe, due to a lack of proposition from the health care providers, and a high refusal rate from the women. The primary aim of this study was to estimate the influenza vaccination coverage (IVC) in a population of pregnant women in France, and to analyse its evolution from 2009 to 2018. The secondary objective was to describe the vaccinated population and to find determinants associated with the vaccination. This retrospective cohort study is based on the EGB French health care database, a representative sample of the French population containing data from the health insurance system. All pregnant women who delivered medically or spontaneously over the 2009-2018 period were included. In the 2009-2018 period, only 1.2% pregnant women were vaccinated against influenza (n = 875/72,207; 95% CI 1.14-1.30). The IVC slightly increased after the 2012 WHO recommendation, from 0.33 to 1.79% (p < 0.001) but remained extremely low (4.1% in 2018). Women younger than 25 years old had a low coverage (0.6%) whereas women over 35 years old were more likely to get the influenza vaccine (1.7%; OR: 2.82, 95% CI 2.14-3.71). The vaccination behavior was not influenced by multifetal pregnancy or parity, but socio-economically deprived women were less likely to be vaccinated (OR: 0.81, 95% CI: 0.67-0.98). Women with pre-existing medical conditions had an overall higher vaccination rate (2.5%; OR: 2.32, 95% CI: 1.94-2.77). The vaccine was mainly prescribed by family physicians (58%). Influenza vaccination in pregnant women in France remains very low, particularly in younger, healthy women, and measures such as information campaigns towards pregnant women and studies of the knowledge, attitudes, and practices of the health care professionals need to be undertaken to improve the coverage.
孕妇患严重流感的风险较高，且与产科并发症相关。自 2012 年起，世界卫生组织（WHO）就建议所有孕妇接种流感疫苗。然而，全球范围内的接种率仍然较低，在欧洲，这是由于医疗服务提供者缺乏建议，以及孕妇的高拒绝率所致。本研究的主要目的是评估法国孕妇的流感疫苗接种覆盖率（IVC），并分析其在 2009 年至 2018 年期间的变化。次要目标是描述接种人群，并找出与接种相关的决定因素。这项回顾性队列研究基于 EGB 法国医疗保健数据库，这是一个具有代表性的法国人群样本，包含来自健康保险系统的数据。所有在 2009 年至 2018 年期间自然分娩或医学分娩的孕妇均被纳入研究。在 2009-2018 年期间，仅有 1.2%的孕妇接种了流感疫苗（n=875/72207；95%CI 1.14-1.30）。自 2012 年世卫组织建议以来，IVC 略有增加，从 0.33%增加到 1.79%（p<0.001），但仍极低（2018 年为 4.1%）。25 岁以下的年轻女性接种率较低（0.6%），而 35 岁以上的女性更有可能接种流感疫苗（1.7%；OR：2.82，95%CI 2.14-3.71）。多胎妊娠或产次并未影响接种行为，但社会经济地位较低的女性接种疫苗的可能性较低（OR：0.81，95%CI：0.67-0.98）。有基础疾病的女性总体上接种率较高（2.5%）（OR：2.32，95%CI：1.94-2.77）。疫苗主要由家庭医生开具（58%）。法国孕妇的流感疫苗接种率仍然很低，尤其是在年轻、健康的女性中，需要开展针对孕妇的宣传活动，并对医疗保健专业人员的知识、态度和实践进行研究，以提高接种率。
