Anna S Howe1, Leah Pointon2, Natalie Gauld3, Janine Paynter4, Esther Willing5, Nikki Turner6. 1. Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, New Zealand. Electronic address: a.howe@auckland.ac.nz. 2. Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, New Zealand. Electronic address: l.pointon@auckland.ac.nz. 3. Department of Paediatrics: Child and Youth Health, University of Auckland, New Zealand; School of Pharmacy, University of Auckland, New Zealand. Electronic address: n.gauld@auckland.ac.nz. 4. Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, New Zealand. Electronic address: j.paynter@auckland.ac.nz. 5. Kōhatu - Centre for Hauora Māori, Division of Health Sciences, University of Otago, New Zealand. Electronic address: esther.willing@otago.ac.nz. 6. Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, New Zealand; Immunisation Advisory Centre, University of Auckland, New Zealand. Electronic address: n.turner@auckland.ac.nz.
Abstract
BACKGROUND: Immunisation is an important public health policy and measuring coverage is imperative to identify gaps and monitor trends. New Zealand (NZ), like many countries, does not routinely publish coverage of immunisations given during pregnancy. Therefore, this study examined pregnancy immunisation coverage of all pregnant NZ women between 2013 and 2018, and what factors affected uptake. METHODS: A retrospective cohort study of pregnant women who delivered between 2013 and 2018 was undertaken using administrative datasets. Maternity and immunisation data were linked to determine coverage of pertussis and influenza vaccinations in pregnancy. Generalised estimating equations were used to estimate the odds of receiving a vaccination during pregnancy. RESULTS: From 2013 to 2018 data were available for 323,622 pregnant women, of whom 21.7% received maternal influenza immunisations and 25.7% maternal pertussis immunisations. Coverage for both vaccines increased over time, pertussis increased from 10.2% to 43.6% and influenza from 11.2% to 30.8%. The odds of being vaccinated, with either vaccine, during pregnancy increased with increasing age and decreasing deprivation. Compared to NZ European or Other women, Māori and Pacific women had lower odds of receiving a maternal pertussis (OR:0.55, 95% CI: 0.54, 0.57; OR:0.60, 95% CI: 0.58, 0.62, respectively) and influenza (OR: 0.69, 95% CI: 0.67, 0.71; OR:0.90, 95% CI: 0.87, 0.94, respectively) immunisations during pregnancy. Women were also more likely to be vaccinated against pertussis if they received antenatal care from a General Practitioner or Obstetrician compared to a Midwife. A similar pattern was seen for influenza vaccination. CONCLUSION: Gaps in maternal coverage for pertussis and influenza exist and work is needed to reduce immunisation inequities.
BACKGROUND: Immunisation is an important public health policy and measuring coverage is imperative to identify gaps and monitor trends. New Zealand (NZ), like many countries, does not routinely publish coverage of immunisations given during pregnancy. Therefore, this study examined pregnancy immunisation coverage of all pregnant NZ women between 2013 and 2018, and what factors affected uptake. METHODS: A retrospective cohort study of pregnant women who delivered between 2013 and 2018 was undertaken using administrative datasets. Maternity and immunisation data were linked to determine coverage of pertussis and influenza vaccinations in pregnancy. Generalised estimating equations were used to estimate the odds of receiving a vaccination during pregnancy. RESULTS: From 2013 to 2018 data were available for 323,622 pregnant women, of whom 21.7% received maternal influenza immunisations and 25.7% maternal pertussis immunisations. Coverage for both vaccines increased over time, pertussis increased from 10.2% to 43.6% and influenza from 11.2% to 30.8%. The odds of being vaccinated, with either vaccine, during pregnancy increased with increasing age and decreasing deprivation. Compared to NZ European or Other women, Māori and Pacific women had lower odds of receiving a maternal pertussis (OR:0.55, 95% CI: 0.54, 0.57; OR:0.60, 95% CI: 0.58, 0.62, respectively) and influenza (OR: 0.69, 95% CI: 0.67, 0.71; OR:0.90, 95% CI: 0.87, 0.94, respectively) immunisations during pregnancy. Women were also more likely to be vaccinated against pertussis if they received antenatal care from a General Practitioner or Obstetrician compared to a Midwife. A similar pattern was seen for influenza vaccination. CONCLUSION: Gaps in maternal coverage for pertussis and influenza exist and work is needed to reduce immunisation inequities.
Authors: Anna S Howe; Natalie J Gauld; Alana Y Cavadino; Helen Petousis-Harris; Felicity Dumble; Owen Sinclair; Cameron C Grant Journal: Vaccines (Basel) Date: 2022-01-20
Authors: Natalie Gauld; Samuel Martin; Owen Sinclair; Helen Petousis-Harris; Felicity Dumble; Cameron C Grant Journal: Vaccines (Basel) Date: 2022-01-04