Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA; Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
Institute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA.
Prev Med. 2023 Dec;177:107751. doi: 10.1016/j.ypmed.2023.107751. Epub 2023 Nov 4.
Racial and ethnic disparities in influenza vaccination coverage among pregnant women in the United States have been documented. This study assessed the contribution of vaccine-related attitudes to coverage disparities.
Surveys were conducted following the 2019-2020 and 2020-2021 influenza seasons in a US research network. Using electronic health record data to identify pregnant women, random samples were selected for surveying; non-Hispanic Black women and influenza-unvaccinated women were oversampled. Regression-based decomposition analyses were used to assess the contribution of vaccine-related attitudes to racial and ethnic differences in influenza vaccination. Data were combined across survey years, and analyses were weighted and accounted for survey design.
Survey response rate was 41.2% (721 of 1748) for 2019-2020 and 39.3% (706 of 1798) for 2020-2021. Self-reported influenza vaccination was higher among non-Hispanic White respondents (79.4% coverage, 95% CI 73.1%-85.7%) than Hispanic (66.2% coverage, 95% CI 52.5%-79.9%) and non-Hispanic Black (55.8% coverage, 95% CI 50.2%-61.4%) respondents. For all racial and ethnic groups, a high proportion (generally >80%) reported being seen for care, recommended for influenza vaccination, and offered vaccination. In decomposition analyses, vaccine-related attitudes (e.g., worry about vaccination causing influenza; concern about vaccine safety and effectiveness) explained a statistically significant portion of the observed racial and ethnic disparities in vaccination. Maternal age, education, and health status were not significant contributors after controlling for vaccine-related attitudes.
In a setting with relatively high influenza vaccination coverage among pregnant women, racial and ethnic disparities in coverage were identified. Vaccine-related attitudes were associated with the disparities observed.
美国已记录了孕妇中流感疫苗接种率的种族和民族差异。本研究评估了疫苗相关态度对覆盖差异的贡献。
在 2019-2020 年和 2020-2021 年流感季节，在美国研究网络中进行了调查。使用电子健康记录数据来识别孕妇，然后对调查进行了随机抽样；对非西班牙裔黑人和未接种流感疫苗的妇女进行了超额抽样。基于回归的分解分析用于评估疫苗相关态度对流感疫苗接种的种族和民族差异的贡献。将数据结合在一起，进行了分析，并对调查设计进行了加权和考虑。
2019-2020 年的调查回复率为 41.2%（721/1748），2020-2021 年的调查回复率为 39.3%（706/1798）。自我报告的流感疫苗接种率在非西班牙裔白人受访者中较高（79.4%的覆盖率，95%CI 73.1%-85.7%），而非西班牙裔黑人和西班牙裔受访者（分别为 55.8%和 66.2%的覆盖率，95%CI 50.2%-69.9%）。对于所有种族和族裔群体，很大比例（通常>80%）报告接受了护理、推荐流感疫苗接种和提供疫苗接种。在分解分析中，疫苗相关态度（例如，担心接种会引起流感；对疫苗安全性和有效性的关注）解释了观察到的疫苗接种率的种族和民族差异的很大一部分。在控制了疫苗相关态度后，母亲年龄、教育程度和健康状况并不是重要因素。
在孕妇中流感疫苗接种率相对较高的环境中，发现了覆盖范围的种族和民族差异。疫苗相关态度与观察到的差异有关。
