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新冠疫情期间妊娠期疫苗接种接受度的影响因素:来自印度西孟加拉邦的一项多中心研究。

Factors influencing vaccine acceptance in pregnancy during the COVID-19 pandemic: A multicenter study from West Bengal, India.

机构信息

School of Medical Science & Technology, Indian Institute of Technology Kharagpur, Kharagpur, India.

Department of Obstetrics & Gynaecology, Midnapore Medical College and Hospital, Midnapore, India.

出版信息

Hum Vaccin Immunother. 2024 Dec 31;20(1):2383030. doi: 10.1080/21645515.2024.2383030. Epub 2024 Jul 31.


DOI:10.1080/21645515.2024.2383030
PMID:39082142
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11296540/
Abstract

Influenza, COVID-19, tetanus, pertussis and hepatitis B pose increased risk for pregnant women and infants and could be mitigated by maternal immunization. In India Tetanus-diphtheria (Td) and COVID-19 vaccines are recommended during pregnancy, while influenza and tetanus-acellular pertussis-diphtheria (Tdap) vaccines are not. We conducted a multicenter study from November 2021 to June 2022 among pregnant women ( = 172) attending antenatal clinics in three public hospitals in West Bengal, to understand the factors that influence women's decisions to get vaccinated during pregnancy. Questions assessed vaccination coverage, knowledge, intention and willingness to pay for influenza vaccine, and factors influencing decisions to get Td, influenza, and COVID-19 vaccines. 152/172 (88.4%) women were vaccinated with Td, 159/172 (93%) with COVID-19, 1/172 (0.6%) with influenza, and none with Tdap. 10/168 (6%) had received hepatitis B vaccine (HBV). Community health workers advice was crucial for Td uptake and, the belief of protection from COVID for COVID-19 vaccines. Most women were unaware about Tdap (96%), influenza (75%), and influenza severity during pregnancy and infancy (85%). None were advised for influenza vaccination by healthcare providers (HCP), albeit, 93% expressed willingness to take, and pay INR 100-300 (95% CI: ≤100 to 300-500) [$ 1.3-4.0 (95% CI: ≤1.3, 4-6.7)] for it. Vaccination on flexible dates and time, HCP's recommendation, proximity to vaccination center, and husband's support were most important for their vaccination decisions. Women were generally vaccine acceptors and had high uptake of vaccines included in the Universal Immunization Program (UIP). Inclusion of influenza, Tdap, and HBV into UIP may improve maternal vaccine uptake.

摘要

流感、COVID-19、破伤风、百日咳和乙型肝炎会增加孕妇和婴儿的风险,可以通过母亲免疫来减轻这些风险。在印度,破伤风类毒素-白喉(Td)和 COVID-19 疫苗在怀孕期间被推荐使用,而流感和破伤风-无细胞百日咳-白喉(Tdap)疫苗则不被推荐。我们在 2021 年 11 月至 2022 年 6 月期间在西孟加拉邦的三家公立医院的产前诊所进行了一项多中心研究,以了解影响妇女在怀孕期间接种疫苗的决定的因素。问题评估了疫苗接种覆盖率、知识、接种流感疫苗的意愿和支付意愿,以及影响接种 Td、流感和 COVID-19 疫苗的决定的因素。172 名孕妇中有 152 名(88.4%)接种了 Td,172 名中有 159 名(93%)接种了 COVID-19,172 名中有 1 名(0.6%)接种了流感,172 名中没有接种 Tdap。168 名(6%)孕妇接种了乙肝疫苗(HBV)。社区卫生工作者的建议对 Td 的接种至关重要,而对 COVID-19 疫苗的保护作用的信念也是 COVID-19 疫苗接种的关键。大多数妇女对 Tdap(96%)、流感(75%)以及流感在妊娠和婴儿期的严重程度(85%)一无所知。尽管 93%的妇女表示愿意接种并支付 100-300 卢比(95%置信区间:≤100-300-500)[1.3-4.0(95%置信区间:≤1.3,4-6.7)],但没有卫生保健提供者(HCP)建议接种流感疫苗。灵活的接种日期和时间、HCP 的建议、接种中心的距离以及丈夫的支持是她们接种疫苗的最重要因素。妇女普遍接受疫苗,并且对包括在普遍免疫计划(UIP)中的疫苗的接种率很高。将流感、Tdap 和 HBV 纳入 UIP 可能会提高产妇疫苗接种率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11bf/11296540/848d90a2a5d8/KHVI_A_2383030_F0008_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11bf/11296540/52cd81a164bb/KHVI_A_2383030_F0001_OC.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11bf/11296540/492d93e14c97/KHVI_A_2383030_F0005_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11bf/11296540/ca2a845d395c/KHVI_A_2383030_F0006_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11bf/11296540/8b9592ba36ba/KHVI_A_2383030_F0007_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11bf/11296540/848d90a2a5d8/KHVI_A_2383030_F0008_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11bf/11296540/52cd81a164bb/KHVI_A_2383030_F0001_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11bf/11296540/b75971cfd2e3/KHVI_A_2383030_F0002_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11bf/11296540/578c0e673564/KHVI_A_2383030_F0003_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11bf/11296540/86b31c0237a2/KHVI_A_2383030_F0004_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11bf/11296540/492d93e14c97/KHVI_A_2383030_F0005_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11bf/11296540/ca2a845d395c/KHVI_A_2383030_F0006_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11bf/11296540/8b9592ba36ba/KHVI_A_2383030_F0007_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11bf/11296540/848d90a2a5d8/KHVI_A_2383030_F0008_OC.jpg

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引用本文的文献

[1]
Strengthening the relationship between community resilience and health emergency communication: a systematic review.

BMC Glob Public Health. 2024-11-27

[2]
Facilitators and barriers to maternal immunization and strategies to improve uptake in low-income and lower-middle income countries: A systematic review.

Hum Vaccin Immunother. 2024-12-31

本文引用的文献

[1]
Reconstructing the COVID-19 incidence in India using airport screening data in Japan.

BMC Infect Dis. 2024-1-2

[2]
Maternal Vaccine Effectiveness Against Influenza-Associated Hospitalizations and Emergency Department Visits in Infants.

JAMA Pediatr. 2024-2-1

[3]
Impact of COVID-19 pandemic on routine immunization services in a tertiary care hospital of Rajasthan, India.

Clin Exp Vaccine Res. 2023-10

[4]
The inclusion of pregnant women in vaccine clinical trials: An overview of late-stage clinical trials' records between 2018 and 2023.

Vaccine. 2023-11-22

[5]
Factors Affecting COVID-19 Vaccine Acceptance among Pregnant Women: A Cross Sectional Study from Abha City, Saudi Arabia.

Vaccines (Basel). 2023-9-7

[6]
Knowledge and Practice of Gynecologists About Tdap and Influenza Vaccination: A Cross-Sectional Study.

Cureus. 2023-6-6

[7]
Evaluation of Pertussis Disease in Young Infants in India: A Hospital-Based Multicentric Observational Study.

Indian J Pediatr. 2024-4

[8]
Adverse events following COVID-19 vaccination among pregnant women attending primary health centers: An active-surveillance study.

Vacunas. 2023-5-18

[9]
COVID-19 Vaccine Coverage in India: A District-Level Analysis.

Vaccines (Basel). 2023-5-5

[10]
COVID-19 vaccine decision-making among pregnant and lactating women in Bangladesh.

Vaccine. 2023-6-13

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