(434) A retrospective cohort and cross-sectional survey examining vaccine confidence in an urban pregnant population

Thursday, February 9, 2023

4:00 PM – 5:30 PM

Objective: This study examines vaccine confidence in pregnancy in an urban, safety-net health system by 1) determining vaccination rates for influenza (Flu), tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) and COVID-19 and 2) examining demographic characteristics and patient-reported factors related to vaccine confidence in pregnancy.

Study Design: We determined the yearly prevalence of vaccination for Tdap and Flu during pregnancy in our health system 8/2018 -1/2022 and the monthly prevalence of COVID-19 vaccination 1/2021 - 1/2022 via retrospective cohort design. We conducted a cross-sectional survey 12/14/21 – 4/12/22 using a convenience sample of pregnant individuals. Perceptions/concerns regarding the Flu and COVID-19 vaccinations were tabulated. We used univariate logistic regression models to determine the association of characteristics on vaccination odds.

Results: The vaccination rate for Tdap ranged from 76.8% – 80.7%. The vaccination rate for Flu ranged from 64.5% – 72.5%, decreasing significantly in 2020-2021 when compared to the prior season [OR: 0.70 95% CI: (0.63, 0.77)]. COVID-19 vaccination rate increased from 0.9% in January 2021 to 49.4% by January 2022 (Figure 1). A total of 250 individuals completed the survey (57.2% Hispanic, 69.3% with reported annual household income < $50,000). 72.7% agreed that COVID-19 vaccination was important for fetal and maternal health. The primary concerns about vaccination for Flu and Covid-19 included: “safety for me,” “safety for my baby,” and “side effects for me”. Other findings are reported in Table 1.

Conclusion: Vaccination rates in pregnancy are below recommended levels. Individuals were less likely to receive the Flu vaccine than the Tdap vaccine, especially during the pandemic. COVID-19 vaccination increased steadily. Individuals who were receptive to the COVID-19 vaccine displayed trust in their health clinics and were likely to agree with the importance of vaccination not only for themselves and their pregnancies but also for the health of their community.

Primary & Presenting Author(s)

Claire L. Schultz, MD, MPH (she/her/hers)
Assistant Professor
Denver Health and Hospital Authority
Denver, Colorado, United States

Coauthor(s)

GB
Gabrielle Bau, MS
Rocky Mountain Poison & Drug Safety
Denver, Colorado, United States
AM
Ann Mackey, BS
University of Colorado School of Medicine
Aurora, Colorado, United States
JP
Jessica Phan, BA
University of Colorado School of Medicine
Aurora, Colorado, United States
JC
John Curtin, MD
Denver Health and Hospital Authority
Denver, Colorado, United States
JS
Judith Shlay, MD, MSPH
Denver Public Health
Denver, Colorado, United States
NL
Nicole Larrea, MD, MPH
Obstetrician and Gynecologist
Denver Health Medical Center
Denver, Colorado, United States