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Factors Associated with Antenatal Influenza Vaccination in a Medically Underserved Population.

ABSTRACT: Influenza infection in pregnant women is associated with increased risk of morbidity and mortality. Despite recommendations for all women to receive the seasonal influenza vaccine during pregnancy, vaccination rates among pregnant women in the U.S. have remained around 50%. The objective of this study was to evaluate clinical and demographic factors associated with antenatal influenza vaccination in a medically underserved population of women. We conducted a retrospective cohort study at Grady Memorial Hospital, a large safety-net hospital in Atlanta, Georgia, from July 1, 2016, to June 30, 2018. Demographic and clinical characteristics were abstracted from the electronic medical record. The Kotelchuck index was used to assess prenatal care adequacy. Relative risks and 95% confidence intervals for associations between receipt of influenza vaccine and prenatal care adequacy, demographic characteristics, and clinical characteristics were calculated using multivariable log-binominal models. Among 3723 pregnant women with deliveries, women were primarily non-Hispanic black (68.4%) and had Medicaid as their primary insurance type (87.9%). The overall vaccination rate was 49.8% (1853/3723). Inadequate prenatal care adequacy was associated with a lower antenatal influenza vaccination rate (43.5%), while intermediate and higher levels of prenatal care adequacy were associated with higher vaccination rates (66.9-68.3%). Hispanic ethnicity, non-Hispanic other race/ethnicity, interpreter use for a language other than Spanish, and preexisting diabetes mellitus were associated with higher vaccination coverage in multivariable analyses. Among medically underserved pregnant women, inadequate prenatal care utilization was associated with a lower rate of antenatal influenza vaccination. Socially disadvantaged women may face individual and structural barriers when accessing prenatal care, suggesting that evidenced-based, tailored approaches may be needed to improve prenatal care utilization and antenatal influenza vaccination rates.

SUBMITTER: Adams JC

PROVIDER: S-EPMC7204164 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Factors Associated with Antenatal Influenza Vaccination in a Medically Underserved Population.

Adams Jenna C JC Biswas Hope H HH Boulet Sheree L SL Doraivelu Kamini K Saums Michele K MK Haddad Lisa L Jamieson Denise J DJ

Infectious diseases in obstetrics and gynecology 20200127

Influenza infection in pregnant women is associated with increased risk of morbidity and mortality. Despite recommendations for all women to receive the seasonal influenza vaccine during pregnancy, vaccination rates among pregnant women in the U.S. have remained around 50%. The objective of this study was to evaluate clinical and demographic factors associated with antenatal influenza vaccination in a medically underserved population of women. We conducted a retrospective cohort study at Grady M ...[more]

PMID: 32410818

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Project description:BACKGROUND: The rate of influenza vaccination in Japan has declined over the past several decades. It is essential to identify community-specific factors that affect attitudes toward vaccination, but such parameters have not yet been fully determined in Japan. The present study used the Health Belief Model (HBM) to identify perceptions of influenza vaccination in a rural Japanese community. METHODS: All subjects were residents of a rural town in the southern part of Kyoto, Japan. An anonymous self-administered questionnaire was mailed to 846 randomly chosen households (containing 2,665 subjects). The survey explored gender, age, history of influenza, and factors associated with obtaining influenza vaccination, based on the HBM. RESULTS: A total of 1,182 valid responses (response rate, 44.4%) were received. Sources of information that were associated with vaccination decisions were medical facilities for children (OR=4.21; 95% CI: 1.17-15.1), workplaces for adults (OR=2.40; 95% CI: 1.22-4.75), medical facilities, town office and family for elderly subjects (OR=6.18; 95% CI: 2.42-15.7, OR=5.59; 95% CI: 2.26-13.8 and OR=3.29; 95% CI: 1.01-10.6). Subjects, in all age groups, who strongly agreed that the vaccine was effective were significantly more likely to be vaccinated (OR=10.5; 95% CI: 2.68-41.7 for children; OR=8.85; 95% CI: 4.61-16.9 for adults; OR=19.9; 95% CI: 8.28-48.0 for the elderly). The vaccination rate of elderly subjects who expressed concerns regarding adverse vaccine effects (OR=0.34, 95% CI: 0.15-0.78) or who were worried about practical barriers to the vaccination process (OR=0.13; 95% CI: 0.05-0.31) was significantly lower than in other populations. CONCLUSIONS: Our results indicate that vaccination coverage can be increased if accurate information on personal risk, severity of influenza illness, and efficacy of vaccination are provided by responsible information sources that are easily accessible. Such sources include medical facilities and municipal offices. In addition, barriers and inconveniences associated with vaccination should be removed, especially if they impact on elderly people.

Dataset Information

Factors Associated with Antenatal Influenza Vaccination in a Medically Underserved Population.

Publications

Factors Associated with Antenatal Influenza Vaccination in a Medically Underserved Population.

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