Predictors of tetanus,diphtheria, acellular pertussis and influenza vaccination during pregnancy among full-term deliveries in a medically underserved population |
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| Institution: | 1. Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, United States;2. Department of Gynecology and Obstetrics, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Atlanta, GA 30303, United States;3. Emory University School of Medicine, 201 Dowman Dr, Atlanta, GA 30322, United States;1. School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia;2. National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Kids Research Institute, Children''s Hospital at Westmead, NSW, Australia;1. Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA;2. National Center for Child and Adolescent Health, Ministry of Health, Francisco de P. Miranda 177, Lomas de Plateros, Álvaro Obregón, 01600 Mexico City, Mexico;3. Sanofi Pasteur, Avenida Universidad 1738, Colonia Coyoacán, 04000 Mexico City, Mexico;4. Emory University School of Medicine, 1648 Pierce Drive NE, Atlanta, GA 30322, USA;1. Emory University, Department of Epidemiology and Laney Graduate School, Atlanta, GA, United States;2. Emory University, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, and Division of Infectious Diseases, Department of Medicine, Atlanta, GA, United States;3. Emory University, Rollins School of Public Health, Hubert Department of Global Health, Atlanta, GA, United States;4. Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA, United States;5. Emory University, School of Medicine, Department of Gynecology and Obstetrics, Atlanta, GA, United States;6. University of Kansas Medical Center, Department of Obstetrics and Gynecology, Kansas City, KS, United States;7. Emory University, Emory Vaccine Center and School of Medicine, Atlanta, GA, United States;8. Emory University, Department of Pediatrics, Atlanta, GA, United States;1. Health Protection Surveillance Centre, Dublin, Ireland;2. European Programme for Intervention Epidemiology Training, Stockholm, Sweden;1. KU Leuven, University of Leuven, Department of Pharmaceutical and Pharmacological Sciences, Leuven University Vaccinology Center (LUVAC), B-3000 Leuven, Belgium;2. KU Leuven, University of Leuven, Department of Public Health and Primary Care, Centre for Environment and Health, Youth Health Care, B-3000 Leuven, Belgium;3. KU Leuven, University of Leuven, Department of Development and Regeneration, Department of Obstetrics and Gynaecology, University Hospitals Leuven, B-3000 Leuven, Belgium |
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| Abstract: | ObjectiveTo evaluate predictors of vaccination among women who received tetanus, diphtheria, and acellular pertussis vaccination (Tdap), influenza vaccination, and Tdap and influenza vaccinations.Study DesignIn a retrospective cohort study of all full-term (≥37 weeks gestation) deliveries between July 1, 2016 and June 30, 2018 at a single, safety-net institution, we used multinomial logistic regression models to compare predictors of vaccination among women who received Tdap only, influenza only, and both Tdap and influenza vaccines.ResultsAmong 3132 full-term deliveries, women were primarily non-Hispanic black (67.5%), between the ages of 21–34 (65.3%), and multiparous (76.0%). The rates of only influenza or Tdap vaccination were 10.3% and 21.6%, respectively; 43.3% of women received both vaccines, and 24.9% of women did not receive either vaccine. In the adjusted models, Hispanic ethnicity was positively associated with receipt of all types of vaccination and non-Spanish language interpreter use was positively associated with receipt of Tdap vaccination and Tdap and influenza vaccination. A parity of greater than three and inadequate and unknown prenatal care adequacy were negative predictors of all types of vaccination. Pre-existing hypertension was negatively associated with Tdap vaccination, and HIV-positive status was negatively associated with influenza vaccination and Tdap and influenza vaccination.ConclusionCompared to the national rate of both Tdap and influenza vaccination (32.8%), a higher proportion of women received both vaccines in our study population. Vaccine uptake may be affected by race/ethnicity, use of interpreter services, parity, pre-existing comorbidities, and prenatal care adequacy. The lower rate of influenza vaccination compared to Tdap vaccination suggests that other factors, such as vaccine hesitancy and mistrust, may be differentially impacting influenza vaccination uptake in our predominantly minority population. Future provider and public health approaches to vaccine promotion should incorporate culturally appropriate strategies that address vaccine-related beliefs and misconceptions. |
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| Keywords: | Antenatal vaccination predictors Tdap Influenza vaccination |
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