Temporal trends and determinants of COVID-19 vaccine coverage and series initiation during pregnancy in Ontario, Canada, December 2020 to December 2021: A population-based retrospective cohort study

被引：13

作者：

Fell, Deshayne B. ^{[1
,2
,26
]}

Toeroek, Eszter ^{[1
,3
]}

Sprague, Ann E. ^{[1
,3
]}

Regan, Annette K. ^{[4
,5
]}

Dhinsa, Tavleen ^{[3
]}

Alton, Gillian D. ^{[1
,3
]}

Dimanlig-Cruz, Sheryll ^{[2
,3
]}

MacDonald, Shannon E. ^{[6
,7
,8
]}

Buchan, Sarah A. ^{[9
,10
]}

Kwong, Jeffrey C. ^{[9
,10
,11
,12
]}

Wilson, Sarah E. ^{[9
,10
]}

Haberg, Siri E. ^{[13
]}

Gravel, Christopher A. ^{[2
,14
,17
]}

Wilson, Kumanan ^{[15
,16
]}

Dunn, Sandra I. ^{[1
,18
]}

Shah, Prakesh S. ^{[19
,20
,21
,22
]}

El-Chaar, Darine ^{[2
,15
,23
]}

Barrett, Jon ^{[24
]}

Walker, Mark C. ^{[1
,23
]}

Okun, Nannette ^{[25
]}

Dougan, Shelley D.

机构：

[1] Childrens Hosp Eastern Ontario CHEO Res Inst, Ottawa, ON, Canada

[2] Univ Ottawa, Sch Epidemiol & Publ Hlth, Ottawa, ON, Canada

[3] Better Outcomes Registry & Network BORN Ontario, Ottawa, ON, Canada

[4] Univ San Francisco, Sch Nursing & Hlth Profess, San Francisco, CA USA

[5] UCLA, Dept Epidemiol, Fielding Sch Publ Hlth, Los Angeles, CA USA

[6] Univ Alberta, Fac Nursing, Edmonton, AB, Canada

[7] Univ Alberta, Sch Publ Hlth, Edmonton, AB, Canada

[8] Univ Calgary, Dept Pediat, Calgary, AB, Canada

[9] Publ Hlth Ontario, Toronto, ON, Canada

[10] Univ Toronto, Dalla Lana Sch Publ Hlth, Toronto, ON, Canada

[11] ICES, Toronto, ON, Canada

[12] Univ Toronto, Dept Family & Community Med, Toronto, ON, Canada

[13] Norwegian Inst Publ Hlth, Ctr Fertil & Hlth, Oslo, Norway

[14] McGill Univ, Dept Epidemiol Biostat & Occupat Hlth, Montreal, PQ, Canada

[15] Ottawa Hosp Res Inst, Clin Epidemiol Program, Ottawa, ON, Canada

[16] Univ Ottawa, Dept Med, Ottawa, ON, Canada

[17] Res Inst, Ottawa, ON, Canada

[18] Univ Ottawa, Sch Nursing, Ottawa, ON, Canada

[19] Mt Sinai Hosp, Dept Pediat, Toronto, ON, Canada

[20] Univ Toronto, Dept Pediat, Toronto, ON, Canada

[21] Mt Sinai Hosp, Maternal infant Care Res Ctr, Dept Pediat, Toronto, ON, Canada

[22] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada

[23] Univ Ottawa, Dept Obstet & Gynecol, Ottawa, ON, Canada

[24] McMaster Univ, Dept Obstet & Gynecol, Hamilton, ON, Canada

[25] Univ Toronto, Dept Obstet & Gynaecol, Toronto, ON, Canada

[26] Ctr Practice Changing Res, 401 Smyth Rd, Room L1154, Ottawa, ON K1H 8L1, Canada

来源：

VACCINE | 2023年 / 41卷 / 10期

关键词：

COVID-19; vaccination; Pregnancy; Vaccine coverage; Vaccine series initiation; HEALTH-CARE ORGANIZATIONS; INFLUENZA VACCINATION; UNITED-STATES; WOMEN;

D O I：

10.1016/j.vaccine.2023.01.073

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background: Population-based COVID-19 vaccine coverage estimates among pregnant individuals are limited. We assessed temporal patterns in vaccine coverage (>= 1 dose before or during pregnancy) and evaluated factors associated with vaccine series initiation (receiving dose 1 during pregnancy) in Ontario, Canada.Methods: We linked the provincial birth registry with COVID-19 vaccination records from December 14, 2020 to December 31, 2021 and assessed coverage rates among all pregnant individuals by month, age, and neighborhood sociodemographic characteristics. Among individuals who gave birth since April 2021-when pregnant people were prioritized for vaccination-we assessed associations between sociodemographic, behavioral, and pregnancy-related factors with vaccine series initiation using multi -variable regression to estimate adjusted risk ratios (aRR) and risk differences (aRD) with 95% confidence intervals (CI).Results: Among 221,190 pregnant individuals, vaccine coverage increased to 71.2% by December 2021. Gaps in coverage across categories of age and sociodemographic characteristics decreased over time, but did not disappear. Lower vaccine series initiation was associated with lower age (<25 vs. 30-34 years: aRR 0.53, 95%CI 0.51-0.56), smoking (vs. non-smoking: 0.64, 0.61-0.67), no first trimester prenatal care visit (vs. visit: 0.80, 0.77-0.84), and residing in neighborhoods with the lowest income (vs. highest: 0.69, 0.67-0.71). Vaccine series initiation was marginally higher among individuals with pre-existing medical conditions (vs. no conditions: 1.07, 1.04-1.10). Conclusions: COVID-19 vaccine coverage among pregnant individuals remained lower than in the general population, and there was lower vaccine initiation by multiple characteristics.(c) 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

引用

页码：1716 / 1725

页数：10

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