tetano
Editor, Senior Moderator
Failure of the vaccination campaign against A(H1N1) influenza in pregnant women in France: Results from a national survey
B?atrice Blondela, b, Corresponding author contact information, E-mail the corresponding author,
Nada Mahjouba, b,
Nicolas Drewniaka, b,
Odile Launayc, d,
Fran?ois Goffineta, d, e
a INSERM, UMRS 953, Epidemiological Research Unit on Perinatal and Women's and Children's Health, Paris, France
b UPMC Univ Paris 06, Paris, France
c INSERM, CIC BT505, Assistance Publique-H?pitaux de Paris, H?pital Cochin, Centre d?Investigation Clinique de Vaccinologie Cochin Pasteur, Paris, France
d Universit? Paris-Descartes, Paris, France
e Maternit? Port-Royal, H?pital Cochin, Assistance Publique-H?pitaux de Paris, Paris, France
Received 23 February 2012. Revised 22 June 2012. Accepted 26 June 2012. Available online 7 July 2012.
http://dx.doi.org/10.1016/j.vaccine.2012.06.077, How to Cite or Link Using DOI
Background and objective
Pregnant women were a priority group for vaccination during the 2009 A(H1N1) influenza pandemic. In France, vaccination was organized in ad hoc centers. Women received vouchers by mail and were given a non-adjuvanted vaccine. Our objective was to assess the national vaccination rate among pregnant women and to determine the association of vaccination with maternal characteristics, prenatal care, and pregnancy-related health behaviors.
Method
Data came from a national representative sample of women who gave birth in March 2010 (N = 13 453) and were interviewed in the hospital before discharge; they were in the second trimester of pregnancy during the vaccination campaign. Associations between vaccination and socio-demographic and medical characteristics, region of residence, care providers, and preventive behaviors were assessed with bivariable analyses and logistic regression models.
Results
Vaccine coverage was 29.3% (95% CI: 28.6?30.1). The main reason for not being vaccinated was that women did not want this immunization (91%). In adjusted analyses, vaccination was more frequent in women who were older, employed, born in France, with a parity of 1 or 2 and specific favourable health behaviors. The adjusted odds ratio for women with a postgraduate educational level was 4.1 (95% CI: 3.5?4.8) compared to those who did not complete high school. Women with additional risk factors for complications from A(H1N1) infection had a vaccination rate similar to that of other women.
Conclusion
The vaccination campaign resulted in poor vaccination coverage, strong social inequalities, and no special protection for pregnant women at the highest risk of complications. These findings provide essential information for the organization of future vaccination campaigns.
Highlights
► We studied pandemic flu vaccination rates among pregnant women. ► A high educational level was the main factor linked to vaccination uptake. ► Women at high risk of flu complications did not have higher vaccination rates. ► The low adherence in some groups should be a concern in future campaigns.
http://www.sciencedirect.com/science/article/pii/S0264410X12009589
B?atrice Blondela, b, Corresponding author contact information, E-mail the corresponding author,
Nada Mahjouba, b,
Nicolas Drewniaka, b,
Odile Launayc, d,
Fran?ois Goffineta, d, e
a INSERM, UMRS 953, Epidemiological Research Unit on Perinatal and Women's and Children's Health, Paris, France
b UPMC Univ Paris 06, Paris, France
c INSERM, CIC BT505, Assistance Publique-H?pitaux de Paris, H?pital Cochin, Centre d?Investigation Clinique de Vaccinologie Cochin Pasteur, Paris, France
d Universit? Paris-Descartes, Paris, France
e Maternit? Port-Royal, H?pital Cochin, Assistance Publique-H?pitaux de Paris, Paris, France
Received 23 February 2012. Revised 22 June 2012. Accepted 26 June 2012. Available online 7 July 2012.
http://dx.doi.org/10.1016/j.vaccine.2012.06.077, How to Cite or Link Using DOI
Background and objective
Pregnant women were a priority group for vaccination during the 2009 A(H1N1) influenza pandemic. In France, vaccination was organized in ad hoc centers. Women received vouchers by mail and were given a non-adjuvanted vaccine. Our objective was to assess the national vaccination rate among pregnant women and to determine the association of vaccination with maternal characteristics, prenatal care, and pregnancy-related health behaviors.
Method
Data came from a national representative sample of women who gave birth in March 2010 (N = 13 453) and were interviewed in the hospital before discharge; they were in the second trimester of pregnancy during the vaccination campaign. Associations between vaccination and socio-demographic and medical characteristics, region of residence, care providers, and preventive behaviors were assessed with bivariable analyses and logistic regression models.
Results
Vaccine coverage was 29.3% (95% CI: 28.6?30.1). The main reason for not being vaccinated was that women did not want this immunization (91%). In adjusted analyses, vaccination was more frequent in women who were older, employed, born in France, with a parity of 1 or 2 and specific favourable health behaviors. The adjusted odds ratio for women with a postgraduate educational level was 4.1 (95% CI: 3.5?4.8) compared to those who did not complete high school. Women with additional risk factors for complications from A(H1N1) infection had a vaccination rate similar to that of other women.
Conclusion
The vaccination campaign resulted in poor vaccination coverage, strong social inequalities, and no special protection for pregnant women at the highest risk of complications. These findings provide essential information for the organization of future vaccination campaigns.
Highlights
► We studied pandemic flu vaccination rates among pregnant women. ► A high educational level was the main factor linked to vaccination uptake. ► Women at high risk of flu complications did not have higher vaccination rates. ► The low adherence in some groups should be a concern in future campaigns.
http://www.sciencedirect.com/science/article/pii/S0264410X12009589