Disparities in Influenza Vaccination Coverage Among Women with Live-Born Infants: PRAMS Surveillance During the 2009-2010 Influenza Season
Disparities in Influenza Vaccination Coverage Among Women with Live-Born Infants: PRAMS Surveillance During the 2009-2010 Influenza Season
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DOI：
10.1177/003335491412900504
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发表时间：
2014-09-01
影响因子：
3.3
通讯作者：
Bridges, Carolyn
中科院分区：
文献类型：
--
作者：
Ahluwalia, Indu B.;Ding, Helen;Bridges, Carolyn
目标。怀孕期间接种疫苗可大大降低孕妇及其6个月以下婴儿患流感的风险；然而，许多妇女没有接种疫苗。我们检查了2009-2010年流感季节分娩活产婴儿的妇女接种疫苗覆盖率的差异，当时建议接种两种单独的流感疫苗。从2009-2010年流感季节收集的29个州和纽约市的妊娠风险评估监测系统（PRAMS）数据，用于检查2009年9月1日至2010年5月31日期间分娩活产婴儿的不同种族/民族妇女的季节性（未加权n=27,153）和大流行性甲型H1N1流感pdm09 (pH1N1) （n=27,372）疫苗接种情况。PRAMS数据显示，有活产婴儿的妇女在季节性和甲型h1n1流感疫苗接种覆盖率方面存在种族/族裔群体差异。对于季节性流感疫苗接种，非西班牙裔白人的覆盖率为50.5%，非西班牙裔黑人为30.2%，西班牙裔为42.1%，非西班牙裔其他妇女为48.2%。对于pH1N1，非西班牙裔白人的疫苗接种率为41.4%，非西班牙裔黑人为25.5%，西班牙裔为41.1%，非西班牙裔其他妇女为43.3%。与非西班牙裔白人妇女相比，非西班牙裔黑人妇女的季节性（粗流行比[cPR] = 0.60, 95%可信区间[Cl] 0.55, 0.64）和pH1N1疫苗接种率（cPR=0.62, 95% Cl 0.57, 0.67）较低；在调整了流感疫苗、保险状况和人口统计学因素（季节性疫苗：调整PR [aPR] = 0.80, 95% Cl 0.74, 0.86；甲型h1n1流感疫苗：aPR=0.75, 95% Cl 0.68, 0.82）后，这些差异减小了，但仍然存在。为了减少孕妇接种流感疫苗的差距，可能需要针对提供者的针对性努力和以孕妇和产后妇女为重点的干预措施。
Objectives. Vaccination during pregnancy significantly reduces the risk of influenza illness among pregnant women and their infants up to 6 months of age; however, many women do not get vaccinated. We examined disparities in vaccination coverage among women who delivered a live-born infant during the 2009-2010 influenza season, when two separate influenza vaccinations were recommended.Methods. Pregnancy Risk Assessment Monitoring System (PRAMS) data from 29 states and New York City, collected during the 2009-2010 influenza season, were used to examine uptake of seasonal (unweighted n=27,153) and pandemic influenza A(H1N1)pdm09 (pH1N1) (n=27,372) vaccination by racially/ ethnically diverse women who delivered a live-born infant from September 1, 2009, through May 31, 2010.Results. PRAMS data showed variation in seasonal and pH1N1 influenza vaccination coverage among women with live-born infants by racial/ethnic group. For seasonal influenza vaccination, coverage was 50.5% for non-Hispanic white, 30.2% for non-Hispanic black, 42.1% for Hispanic, and 48.2% for non-Hispanic other women. For pH1N1, vaccination coverage was 41.4% for non-Hispanic white, 25.5% for non-Hispanic black, 41.1% for Hispanic, and 43.3% for non-Hispanic other women. Compared with non-Hispanic white women, non-Hispanic black women had lower seasonal (crude prevalence ratio [cPR] = 0.60, 95% confidence interval [Cl] 0.55, 0.64) and pH1N1 (cPR=0.62, 95% Cl 0.57, 0.67) vaccination coverage; these disparities diminished but remained after adjusting for provider recommendation or offer for influenza vaccination, insurance status, and demographic factors (seasonal vaccine: adjusted PR [aPR] = 0.80, 95% Cl 0.74, 0.86; and pH1N1 vaccine: aPR=0.75, 95% Cl 0.68, 0.82).Conclusion. To reduce disparities in influenza vaccination uptake by pregnant women, targeted efforts toward providers and interventions focusing on pregnant and postpartum women may be needed.