Tweet
Vaccine
. 2025 Oct 28:68:127895.
doi: 10.1016/j.vaccine.2025.127895. Online ahead of print. Trend and factors associated to pertussis and influenza vaccination in pregnant women in Madrid, Spain, 2018-2023 - a retrospective cohort study
María Alejandra López-Zambrano 1 , Amaya Sánchez-Gómez 2 , María Dolores Lasheras Carbajo 3 , María Ángeles Gutierrez Rodríguez 4 , Soledad Cañellas Llabrés 5 , María Vazquez Torres 6 , Marta Molina Olivas 7
Affiliations
Background: Vaccination of pregnant women (PW) is an essential public health measure with benefits for both mothers and newborns. Vaccination against seasonal influenza and pertussis have been recommended in Spain for almost a decade; however, the adherence to this recommendation is variable. The objective of this study was to assess pertussis vaccination coverage (PVC) and influenza vaccination coverage (IVC) among PW in the region of Madrid, Spain, and to explore the factors associated with vaccination.
Methods: We conducted a retrospective cohort study using administrative registries. For PVC 197,984 PW who gave birth between 2019 and 2022 were included in the study. For IVC, 182,014 PW target of the 2018-19 to 2022-23 seasonal influenza campaigns were included. Generalized estimating equations were used to estimate factors associated with vaccination.
Results: The global VC in PW was 87.0 % for pertussis and 53.2 % for influenza. A peak was observed coinciding with the start of COVID-19 vaccination. Factors associated with lower probability of being vaccinated were mother born in a foreign country (Pertussis: aOR:0.73 (95 %CI:0.71-0.76); Influenza: aOR:0.71 (95 %CI:0.69-0.73)), enrolment in public healthcare insurance in last stages or after delivery (Pertussis: aOR:0.04 (95 %CI:0.04-0.05); Influenza: aOR:0.09 (95 %CI:0.08-0.11)) and home births (Pertussis: aOR:0.11 (95 %CI:0.08-0.16); Influenza: aOR:0.22 (95 %CI:0.15-0.31)). PW aged between 30 and 39 years old, with full term pregnancies, who live in areas with middle net incomes and have at least one chronic condition with indication for vaccination were more likely to be vaccinated.
Conclusion: Significant challenges remain to improve vaccination uptake in PW, particularly concerning influenza. These findings may prove useful to tailor strategies to reach specific subgroups within the PW population.
Keywords: Influenza vaccination; Pertussis vaccination; Pregnant women; Regression analysis; Spain; Vaccination coverage.
. 2025 Oct 28:68:127895.
doi: 10.1016/j.vaccine.2025.127895. Online ahead of print. Trend and factors associated to pertussis and influenza vaccination in pregnant women in Madrid, Spain, 2018-2023 - a retrospective cohort study
María Alejandra López-Zambrano 1 , Amaya Sánchez-Gómez 2 , María Dolores Lasheras Carbajo 3 , María Ángeles Gutierrez Rodríguez 4 , Soledad Cañellas Llabrés 5 , María Vazquez Torres 6 , Marta Molina Olivas 7
Affiliations
- PMID: 41161042
- DOI: 10.1016/j.vaccine.2025.127895
Background: Vaccination of pregnant women (PW) is an essential public health measure with benefits for both mothers and newborns. Vaccination against seasonal influenza and pertussis have been recommended in Spain for almost a decade; however, the adherence to this recommendation is variable. The objective of this study was to assess pertussis vaccination coverage (PVC) and influenza vaccination coverage (IVC) among PW in the region of Madrid, Spain, and to explore the factors associated with vaccination.
Methods: We conducted a retrospective cohort study using administrative registries. For PVC 197,984 PW who gave birth between 2019 and 2022 were included in the study. For IVC, 182,014 PW target of the 2018-19 to 2022-23 seasonal influenza campaigns were included. Generalized estimating equations were used to estimate factors associated with vaccination.
Results: The global VC in PW was 87.0 % for pertussis and 53.2 % for influenza. A peak was observed coinciding with the start of COVID-19 vaccination. Factors associated with lower probability of being vaccinated were mother born in a foreign country (Pertussis: aOR:0.73 (95 %CI:0.71-0.76); Influenza: aOR:0.71 (95 %CI:0.69-0.73)), enrolment in public healthcare insurance in last stages or after delivery (Pertussis: aOR:0.04 (95 %CI:0.04-0.05); Influenza: aOR:0.09 (95 %CI:0.08-0.11)) and home births (Pertussis: aOR:0.11 (95 %CI:0.08-0.16); Influenza: aOR:0.22 (95 %CI:0.15-0.31)). PW aged between 30 and 39 years old, with full term pregnancies, who live in areas with middle net incomes and have at least one chronic condition with indication for vaccination were more likely to be vaccinated.
Conclusion: Significant challenges remain to improve vaccination uptake in PW, particularly concerning influenza. These findings may prove useful to tailor strategies to reach specific subgroups within the PW population.
Keywords: Influenza vaccination; Pertussis vaccination; Pregnant women; Regression analysis; Spain; Vaccination coverage.