2020 年 12 月至 2021 年 12 月期间加拿大安大略省 COVID-19 疫苗接种率和孕期系列接种启动的时间趋势和决定因素：一项基于人群的回顾性队列研究。
Temporal trends and determinants of COVID-19 vaccine coverage and series initiation during pregnancy in Ontario, Canada, December 2020 to December 2021: A population-based retrospective cohort study.
机构信息
Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Children's Hospital of Eastern Ontario (CHEO) Research Institute, Ottawa, ON, Canada; Better Outcomes Registry & Network (BORN) Ontario, Ottawa, Ontario, ON, Canada.
出版信息
Vaccine. 2023 Mar 3;41(10):1716-1725. doi: 10.1016/j.vaccine.2023.01.073. Epub 2023 Feb 3.
BACKGROUND
Population-based COVID-19 vaccine coverage estimates among pregnant individuals are limited. We assessed temporal patterns in vaccine coverage (≥1 dose before or during pregnancy) and evaluated factors associated with vaccine series initiation (receiving dose 1 during pregnancy) in Ontario, Canada.
METHODS
We linked the provincial birth registry with COVID-19 vaccination records from December 14, 2020 to December 31, 2021 and assessed coverage rates among all pregnant individuals by month, age, and neighborhood sociodemographic characteristics. Among individuals who gave birth since April 2021-when pregnant people were prioritized for vaccination-we assessed associations between sociodemographic, behavioral, and pregnancy-related factors with vaccine series initiation using multivariable regression to estimate adjusted risk ratios (aRR) and risk differences (aRD) with 95% confidence intervals (CI).
RESULTS
Among 221,190 pregnant individuals, vaccine coverage increased to 71.2% by December 2021. Gaps in coverage across categories of age and sociodemographic characteristics decreased over time, but did not disappear. Lower vaccine series initiation was associated with lower age (<25 vs. 30-34 years: aRR 0.53, 95%CI 0.51-0.56), smoking (vs. non-smoking: 0.64, 0.61-0.67), no first trimester prenatal care visit (vs. visit: 0.80, 0.77-0.84), and residing in neighborhoods with the lowest income (vs. highest: 0.69, 0.67-0.71). Vaccine series initiation was marginally higher among individuals with pre-existing medical conditions (vs. no conditions: 1.07, 1.04-1.10).
CONCLUSIONS
COVID-19 vaccine coverage among pregnant individuals remained lower than in the general population, and there was lower vaccine initiation by multiple characteristics.
背景
人群中 COVID-19 疫苗接种率的估计值在孕妇中是有限的。我们评估了在加拿大安大略省疫苗接种（在怀孕期间接种≥1 剂）的时间模式，并评估了与疫苗接种系列启动（在怀孕期间接种第 1 剂）相关的因素。
方法
我们将省级出生登记处与 2020 年 12 月 14 日至 2021 年 12 月 31 日期间的 COVID-19 疫苗接种记录相链接，并按月、年龄和社区社会人口学特征评估所有孕妇的疫苗接种率。在 2021 年 4 月之后分娩的个体中（此时孕妇优先接种疫苗），我们使用多变量回归评估社会人口学、行为和妊娠相关因素与疫苗接种系列启动之间的关联，以估计调整后的风险比（aRR）和风险差异（aRD）以及 95%置信区间（CI）。
结果
在 221190 名孕妇中，到 2021 年 12 月，疫苗接种率增加到 71.2%。随着时间的推移，年龄和社会人口学特征类别的疫苗接种率差距有所缩小，但并未消失。较低的疫苗接种系列启动与年龄较低（<25 岁与 30-34 岁：aRR 0.53，95%CI 0.51-0.56）、吸烟（与不吸烟：0.64，0.61-0.67）、无孕早期产前保健就诊（与就诊：0.80，0.77-0.84）以及居住在收入最低的社区（与最高：0.69，0.67-0.71）有关。在有预先存在的医疗条件的个体中，疫苗接种系列启动率略高（与无条件：1.07，1.04-1.10）。
结论
孕妇 COVID-19 疫苗接种率仍低于一般人群，且多种特征的疫苗接种启动率较低。
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