tetano
Editor, Senior Moderator
Prev Med
. 2023 Nov 3:107751.
doi: 10.1016/j.ypmed.2023.107751. Online ahead of print. Racial and ethnic disparities in influenza vaccination coverage among pregnant women in the United States: The contribution of vaccine-related attitudes
Matthew F Daley[SUP] 1 [/SUP], Liza M Reifler[SUP] 2 [/SUP], Jo Ann Shoup[SUP] 3 [/SUP], Jason M Glanz[SUP] 4 [/SUP], Allison L Naleway[SUP] 5 [/SUP], Jennifer C Nelson[SUP] 6 [/SUP], Joshua T B Williams[SUP] 7 [/SUP], Huong Q McLean[SUP] 8 [/SUP], Gabriela Vazquez-Benitez[SUP] 9 [/SUP], Kristin Goddard[SUP] 10 [/SUP], Bruno J Lewin[SUP] 11 [/SUP], Eric S Weintraub[SUP] 12 [/SUP], Michael M McNeil[SUP] 13 [/SUP], Hilda Razzaghi[SUP] 14 [/SUP], James A Singleton[SUP] 15 [/SUP]
Affiliations
Objective: Racial and ethnic disparities in influenza vaccination coverage among pregnant women in the United States have been documented. This study assessed the contribution of vaccine-related attitudes to coverage disparities.
Methods: Surveys were conducted following the 2019-2020 and 2020-2021 influenza seasons in a US research network. Using electronic health record data to identify pregnant women, random samples were selected for surveying; non-Hispanic Black women and influenza-unvaccinated women were oversampled. Regression-based decomposition analyses were used to assess the contribution of vaccine-related attitudes to racial and ethnic differences in influenza vaccination. Data were combined across survey years, and analyses were weighted and accounted for survey design.
Results: Survey response rate was 41.2% (721 of 1748) for 2019-2020 and 39.3% (706 of 1798) for 2020-2021. Self-reported influenza vaccination was higher among non-Hispanic White respondents (79.4% coverage, 95% CI 73.1%-85.7%) than Hispanic (66.2% coverage, 95% CI 52.5%-79.9%) and non-Hispanic Black (55.8% coverage, 95% CI 50.2%-61.4%) respondents. For all racial and ethnic groups, a high proportion (generally >80%) reported being seen for care, recommended for influenza vaccination, and offered vaccination. In decomposition analyses, vaccine-related attitudes (e.g., worry about vaccination causing influenza; concern about vaccine safety and effectiveness) explained a statistically significant portion of the observed racial and ethnic disparities in vaccination. Maternal age, education, and health status were not significant contributors after controlling for vaccine-related attitudes.
Conclusions: In a setting with relatively high influenza vaccination coverage among pregnant women, racial and ethnic disparities in coverage were identified. Vaccine-related attitudes were associated with the disparities observed.
Keywords: Attitudes; Coverage; Disparities; Electronic health records; Influenza vaccination; Pregnancy.
. 2023 Nov 3:107751.
doi: 10.1016/j.ypmed.2023.107751. Online ahead of print. Racial and ethnic disparities in influenza vaccination coverage among pregnant women in the United States: The contribution of vaccine-related attitudes
Matthew F Daley[SUP] 1 [/SUP], Liza M Reifler[SUP] 2 [/SUP], Jo Ann Shoup[SUP] 3 [/SUP], Jason M Glanz[SUP] 4 [/SUP], Allison L Naleway[SUP] 5 [/SUP], Jennifer C Nelson[SUP] 6 [/SUP], Joshua T B Williams[SUP] 7 [/SUP], Huong Q McLean[SUP] 8 [/SUP], Gabriela Vazquez-Benitez[SUP] 9 [/SUP], Kristin Goddard[SUP] 10 [/SUP], Bruno J Lewin[SUP] 11 [/SUP], Eric S Weintraub[SUP] 12 [/SUP], Michael M McNeil[SUP] 13 [/SUP], Hilda Razzaghi[SUP] 14 [/SUP], James A Singleton[SUP] 15 [/SUP]
Affiliations
- PMID: 37926397
- DOI: 10.1016/j.ypmed.2023.107751
Objective: Racial and ethnic disparities in influenza vaccination coverage among pregnant women in the United States have been documented. This study assessed the contribution of vaccine-related attitudes to coverage disparities.
Methods: Surveys were conducted following the 2019-2020 and 2020-2021 influenza seasons in a US research network. Using electronic health record data to identify pregnant women, random samples were selected for surveying; non-Hispanic Black women and influenza-unvaccinated women were oversampled. Regression-based decomposition analyses were used to assess the contribution of vaccine-related attitudes to racial and ethnic differences in influenza vaccination. Data were combined across survey years, and analyses were weighted and accounted for survey design.
Results: Survey response rate was 41.2% (721 of 1748) for 2019-2020 and 39.3% (706 of 1798) for 2020-2021. Self-reported influenza vaccination was higher among non-Hispanic White respondents (79.4% coverage, 95% CI 73.1%-85.7%) than Hispanic (66.2% coverage, 95% CI 52.5%-79.9%) and non-Hispanic Black (55.8% coverage, 95% CI 50.2%-61.4%) respondents. For all racial and ethnic groups, a high proportion (generally >80%) reported being seen for care, recommended for influenza vaccination, and offered vaccination. In decomposition analyses, vaccine-related attitudes (e.g., worry about vaccination causing influenza; concern about vaccine safety and effectiveness) explained a statistically significant portion of the observed racial and ethnic disparities in vaccination. Maternal age, education, and health status were not significant contributors after controlling for vaccine-related attitudes.
Conclusions: In a setting with relatively high influenza vaccination coverage among pregnant women, racial and ethnic disparities in coverage were identified. Vaccine-related attitudes were associated with the disparities observed.
Keywords: Attitudes; Coverage; Disparities; Electronic health records; Influenza vaccination; Pregnancy.