Department of Primary Care and Public Health, Imperial College London, London.
Br J Gen Pract. 2023 Jan 26;73(727):e148-e155. doi: 10.3399/BJGP.2022.0078. Print 2023 Feb.
Pregnant women are at increased risk from influenza, yet maternal influenza vaccination levels remain suboptimal.
To estimate associations between sociodemographic and health characteristics and seasonal influenza vaccination uptake among pregnant women, and to understand trends over time to inform interventions to improve vaccine coverage.
Retrospective cohort study using linked electronic health records of women in North West London with a pregnancy overlapping an influenza season between September 2010 and February 2020.
A multivariable mixed-effects logistic regression model was used to identify associations between characteristics of interest and the primary outcome of influenza vaccination.
In total, 451 954 pregnancies, among 260 744 women, were included. In 85 376 (18.9%) pregnancies women were vaccinated against seasonal influenza. Uptake increased from 8.4% in 2010/11 to 26.4% in 2017/18, dropping again to 21.1% in 2019/20. Uptake was lowest among women aged 15-19 years (11.9%; reference category) or ≥40 years (15.2%; odds ratio [OR] 1.17, 95% confidence interval [CI] = 1.10 to 1.24); of Black (14.1%; OR 0.55, 95% CI = 0.53 to 0.57) or unknown ethnicity (9.9%; OR 0.42, 95% CI = 0.39 to 0.46); who lived in more deprived areas (OR least versus most deprived [reference category] 1.16, 95% CI = 1.11 to 1.21); or with no known risk factors for severe influenza.
Seasonal influenza vaccine uptake in pregnant women increased in the decade before the COVID-19 pandemic, but remained suboptimal. Targeted approaches are recommended to reducing inequalities in access to vaccination and should focus on women of Black ethnicity, younger and older women, and women living in deprived areas.
孕妇患流感的风险增加，但孕妇流感疫苗接种率仍不理想。
评估社会人口学和健康特征与孕妇季节性流感疫苗接种率之间的关联，并了解随时间推移的趋势，以为提高疫苗覆盖率的干预措施提供信息。
使用 2010 年 9 月至 2020 年 2 月期间伦敦西北部妊娠重叠流感季节的妇女的电子健康记录进行回顾性队列研究。
使用多变量混合效应逻辑回归模型，确定感兴趣特征与主要结局（流感疫苗接种）之间的关联。
共纳入 260744 名妇女的 451954 例妊娠。85376 例（18.9%）妊娠妇女接种了季节性流感疫苗。疫苗接种率从 2010/11 年的 8.4%上升到 2017/18 年的 26.4%，在 2019/20 年再次下降到 21.1%。在年龄为 15-19 岁（11.9%；参考类别）或≥40 岁（15.2%；比值比[OR]1.17，95%置信区间[CI]1.10-1.24）；黑种人（14.1%；OR0.55，95%CI0.53-0.57）或未知种族（9.9%；OR0.42，95%CI0.39-0.46）；居住在较贫困地区（OR最低与最贫困[参考类别]1.16，95%CI1.11-1.21）；或无严重流感高危因素的孕妇中，疫苗接种率最低。
在 COVID-19 大流行前的十年中，孕妇季节性流感疫苗接种率有所增加，但仍不理想。建议采取有针对性的方法来减少获得疫苗接种的不平等，并应重点关注黑人种族、年轻和年长的妇女以及居住在贫困地区的妇女。
