Health and socio-demographic characteristics associated with uptake of seasonal influenza vaccination amongst pregnant women: Retrospective cohort study

Abstract

Pregnant women are at increased risk from influenza, yet maternal influenza vaccination levels remain suboptimal. This study aimed to estimate associations between socio-demographic and health characteristics and seasonal influenza vaccination uptake among pregnant women and understand trends over time to inform interventions to improve vaccine coverage. A retrospective cohort study using linked electronic health records of women in North West London with at least one pregnancy overlapping with an influenza season between September 2010 and February 2020. We used a multivariable mixed-effects logistic regression model to identify associations between characteristics of interest and primary outcome of influenza vaccination. 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 26.3% in 2018/19, dropping again to 21.1% in 2019/20. Uptake was lowest among women: aged 15-19 years (12%) or over 40 years (15%; OR 1.17, 95% CI 1.10 to 1.24); of Black ethnicity (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), lived in more deprived areas (OR least vs most deprived 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 past decade, prior to the COVID-19 pandemic, but remained suboptimal. We recommend approaches to reducing health inequalities should focus on women of Black ethnicity, younger and older women, and women living in areas of greater socio-economic deprivation.

Acceptance and Risk Perception of COVID-19 Vaccination among Pregnant and Non Pregnant Women in Sub-Saharan Africa: A Cross-Sectional Matched-Sample Study

“…Interestingly, it can be seen from this study that more pregnant women took the COVID-19 vaccine compared to the flu vaccine (about 30% vs. less than 20%). A similar report was given in a retrospective study [ 28 ], where just under 20% of pregnant women out of about 500,000 got vaccinated against influenza. The fact that influenza is not easily differentiated from other rampant infectious diseases (presenting with fever), such as malaria, which occur in the tropics [ 29 ], may have accounted for less attention being paid to this vaccination.…”

Uptake rates and attitudes to influenza and COVID-19 vaccination in pregnancy – a prospective cohort study

“…In the UK, seasonal influenza vaccine uptake in pregnant women has increased in the decade before the COVID-19 pandemic, but still remain low, with rates of 43.6% in 2020/21 taken from Public Health England [ 18 ]. This Irish based prospective cohort study found that the rate of influenza vaccine uptake in pregnancy has risen significantly to 57% (n = 377) from 39% in a similar study in the same hospital in 2016 [ 15 ].…”

“Figuring stuff out myself” – a qualitative study on maternal vaccination in socially and ethnically diverse areas in England

“…recently given birth) women and health service providers in South London. We focused on those South London boroughs (Southwark, Lambeth, Lewisham and Croydon) and areas within these boroughs with populations who, based on Index of Multiple Deprivation (IMD) and ethnicity, were less likely to accept or access maternal vaccinations [ 14 – 17 , 24 , 41 ].…”