tetano
Editor, Senior Moderator
Am J Obstet Gynecol MFM
. 2022 Feb 28;100603.
doi: 10.1016/j.ajogmf.2022.100603. Online ahead of print.
nnAssociation between Social Vulnerability and Influenza and Tetanus-diphtheria-acellular pertussis Vaccination Uptake in Pregnant and Postpartum Individuals
Miranda K Kiefer[SUP] 1 [/SUP], Rebecca Mehl[SUP] 1 [/SUP], Maged M Costantine[SUP] 1 [/SUP], Mark B Landon[SUP] 1 [/SUP], Anna Bartholomew[SUP] 1 [/SUP], Divya Mallampati[SUP] 2 [/SUP], Tracy Manuck[SUP] 2 [/SUP], William Grobman[SUP] 1 [/SUP], Kara M Rood[SUP] 1 [/SUP], Kartik K Venkatesh[SUP] 3 [/SUP]
Affiliations
Abstract
Background: Despite current guidelines recommending universal vaccination, the frequency of vaccination in pregnancy for influenza and tetanus-diphtheria-acellular pertussis (Tdap) remains low.
Objective: To evaluate the association between community-level social vulnerability and influenza and anticipated Tdap vaccination among pregnant and postpartum individuals.
Study design: We conducted a cross-sectional survey of vaccine hesitancy in the peripartum period among pregnant and postpartum individuals enrolled in prenatal care at a single tertiary care center from 03/22/21 to 04/02/21. Individual participant addresses were geocoded using ArGIS, and then linked at the census tract level. The primary exposure was community-level social vulnerability as measured by the U.S. Center for Disease Control and Prevention's Social Vulnerability Index (SVI). This index incorporates 15 census variables to produce a composite score, as well as subscores across 4 major thematic domains (socioeconomic status, household composition and disability, minority status and language, and housing type and transportation). Scores range from 0 to 1, with higher values indicating greater social vulnerability. The primary outcomes were self-reported influenza vaccination during the current influenza season and having received or planning to receive the Tdap vaccination in pregnancy. We used multivariable logistic regression, and adjusted for age, self-reported race and ethnicity, parity, trimester of pregnancy, and chronic comorbid conditions.
Results: Of 456 assessed individuals (95% pregnant, 5% postpartum), the frequency of influenza vaccination was 58% (95%CI: 53-62%) and anticipated Tdap vaccination was 72% (95%CI: 68-76%). Individuals from communities with a higher SVI were less likely to report vaccination in pregnancy versus those from communities with a lower SVI. Specifically, for each 0.1-unit increase in SVI, the odds of influenza vaccination (aOR: 0.23; 95% CI: 0.11 to 0.46) as well as anticipated Tdap vaccination (aOR: 0.24; 95%CI: 0.11 to 0.53) decreased by over 70%. By domain, the SVI subscores of socioeconomic status (influenza aOR: 0.20; 95% CI: 0.10 to 0.40; Tdap aOR: 0.25; 95% CI: 0.12 to 0.53) and housing type and transportation (influenza aOR: 0.41; 95% CI: 0.19 to 0.84; Tdap aOR: 0.39; 95% CI: 0.18 to 0.87) were inversely associated with a lower odds of influenza and Tdap vaccination.
Conclusion: Pregnant and postpartum individuals living in areas with higher social vulnerability were less likely to report influenza and anticipated Tdap vaccination in pregnancy. The SVI could be used as a tool to improve vaccine equity and address disparities in vaccination in pregnancy.
Keywords: Influenza; Tdap; pregnancy; social vulnerability; vaccination; vaccine hesitancy; vaccine uptake.
. 2022 Feb 28;100603.
doi: 10.1016/j.ajogmf.2022.100603. Online ahead of print.
nnAssociation between Social Vulnerability and Influenza and Tetanus-diphtheria-acellular pertussis Vaccination Uptake in Pregnant and Postpartum Individuals
Miranda K Kiefer[SUP] 1 [/SUP], Rebecca Mehl[SUP] 1 [/SUP], Maged M Costantine[SUP] 1 [/SUP], Mark B Landon[SUP] 1 [/SUP], Anna Bartholomew[SUP] 1 [/SUP], Divya Mallampati[SUP] 2 [/SUP], Tracy Manuck[SUP] 2 [/SUP], William Grobman[SUP] 1 [/SUP], Kara M Rood[SUP] 1 [/SUP], Kartik K Venkatesh[SUP] 3 [/SUP]
Affiliations
- PMID: 35240346
- DOI: 10.1016/j.ajogmf.2022.100603
Abstract
Background: Despite current guidelines recommending universal vaccination, the frequency of vaccination in pregnancy for influenza and tetanus-diphtheria-acellular pertussis (Tdap) remains low.
Objective: To evaluate the association between community-level social vulnerability and influenza and anticipated Tdap vaccination among pregnant and postpartum individuals.
Study design: We conducted a cross-sectional survey of vaccine hesitancy in the peripartum period among pregnant and postpartum individuals enrolled in prenatal care at a single tertiary care center from 03/22/21 to 04/02/21. Individual participant addresses were geocoded using ArGIS, and then linked at the census tract level. The primary exposure was community-level social vulnerability as measured by the U.S. Center for Disease Control and Prevention's Social Vulnerability Index (SVI). This index incorporates 15 census variables to produce a composite score, as well as subscores across 4 major thematic domains (socioeconomic status, household composition and disability, minority status and language, and housing type and transportation). Scores range from 0 to 1, with higher values indicating greater social vulnerability. The primary outcomes were self-reported influenza vaccination during the current influenza season and having received or planning to receive the Tdap vaccination in pregnancy. We used multivariable logistic regression, and adjusted for age, self-reported race and ethnicity, parity, trimester of pregnancy, and chronic comorbid conditions.
Results: Of 456 assessed individuals (95% pregnant, 5% postpartum), the frequency of influenza vaccination was 58% (95%CI: 53-62%) and anticipated Tdap vaccination was 72% (95%CI: 68-76%). Individuals from communities with a higher SVI were less likely to report vaccination in pregnancy versus those from communities with a lower SVI. Specifically, for each 0.1-unit increase in SVI, the odds of influenza vaccination (aOR: 0.23; 95% CI: 0.11 to 0.46) as well as anticipated Tdap vaccination (aOR: 0.24; 95%CI: 0.11 to 0.53) decreased by over 70%. By domain, the SVI subscores of socioeconomic status (influenza aOR: 0.20; 95% CI: 0.10 to 0.40; Tdap aOR: 0.25; 95% CI: 0.12 to 0.53) and housing type and transportation (influenza aOR: 0.41; 95% CI: 0.19 to 0.84; Tdap aOR: 0.39; 95% CI: 0.18 to 0.87) were inversely associated with a lower odds of influenza and Tdap vaccination.
Conclusion: Pregnant and postpartum individuals living in areas with higher social vulnerability were less likely to report influenza and anticipated Tdap vaccination in pregnancy. The SVI could be used as a tool to improve vaccine equity and address disparities in vaccination in pregnancy.
Keywords: Influenza; Tdap; pregnancy; social vulnerability; vaccination; vaccine hesitancy; vaccine uptake.