Pertussis and influenza immunisation coverage of pregnant women in New Zealand.


Journal

Vaccine
ISSN: 1873-2518
Titre abrégé: Vaccine
Pays: Netherlands
ID NLM: 8406899

Informations de publication

Date de publication:
07 10 2020
Historique:
received: 27 05 2020
revised: 11 08 2020
accepted: 14 08 2020
pubmed: 2 9 2020
medline: 28 4 2021
entrez: 2 9 2020
Statut: ppublish

Résumé

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. 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. 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. Gaps in maternal coverage for pertussis and influenza exist and work is needed to reduce immunisation inequities.

Sections du résumé

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.

Identifiants

pubmed: 32868133
pii: S0264-410X(20)31071-9
doi: 10.1016/j.vaccine.2020.08.030
pii:
doi:

Substances chimiques

Influenza Vaccines 0
Pertussis Vaccine 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

6766-6776

Informations de copyright

Copyright © 2020 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: NG is a member of the National Executive of the Pharmaceutical Society of New Zealand and has received funding from Green Cross Health (a provider of primary health care services including pharmacy and general practice), the Pharmacy Guild of New Zealand and the Pharmaceutical Society of New Zealand for reclassifying vaccinations to allow pharmacist administration. NG has led an investigator-led study funded by GSK. JP and ASH have been investigators on GSK funded studies.

Auteurs

Anna S Howe (AS)

Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, New Zealand. Electronic address: a.howe@auckland.ac.nz.

Leah Pointon (L)

Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, New Zealand. Electronic address: l.pointon@auckland.ac.nz.

Natalie Gauld (N)

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.

Janine Paynter (J)

Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, New Zealand. Electronic address: j.paynter@auckland.ac.nz.

Esther Willing (E)

Kōhatu - Centre for Hauora Māori, Division of Health Sciences, University of Otago, New Zealand. Electronic address: esther.willing@otago.ac.nz.

Nikki Turner (N)

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.

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