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Influenza vaccine during pregnancy, recommendations from healthcare providers, and race/ethnicity in the United States

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objectives

We examined racial/ethnic differences in the association between influenza vaccine recommendations from healthcare providers and maternal vaccination uptake.

Methods

This cross-sectional study examined data from the Pregnancy Risk Assessment Monitoring System. We categorized respondents as non-Hispanic (NH) Whites, NH-Blacks, NH-Asians, American Indians/Alaska Natives, NH Other non-Whites, and Hispanics. We conducted multivariable logistical regression models to evaluate adjusted odds ratios (AOR) and 95% confidence intervals (CI). Covariates included maternal age, marital status, education, insurance status before pregnancy, the number of previous live births, the number of prenatal care visits, and smoking status during pregnancy.

Results

The prevalences of receiving influenza vaccine recommendations from healthcare providers and maternal vaccine were 80.01% and 50.42%, respectively. NH-Blacks are less likely to receive provider recommendations (AOR = 0.82; 95%CI 0.77–0.87) and be vaccinated (AOR = 0.76; 95%CI 0.72−0.80) than NH-Whites. Receiving provider recommendations was significantly associated with increased maternal influenza vaccine uptake (AOR = 15.50; 95% CI 14.51–16.55). The associations were significant for all racial/ethnic groups, with the highest among NH-Asians (AOR = 22.04; 95% CI 17.88−27.16) and the lowest among NH Other non-Whites (AOR = 11.07; 95% CI 8.25−14.86). Within NH-Asians, effectiveness among Chinese was highest (AOR = 29.39; 95% CI 18.10−47.71).

Conclusions

Racial/ethnic disparities in maternal influenza vaccine uptake and receiving vaccine recommendations from healthcare providers persisted. Further studies on the racial/ethnic disparities in maternal vaccination were warranted and tailored strategies are required to reduce this health disparity.

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Data availability

The PRAMS dataset analyzed in the current study is available from the CDC PRAMS website on request/application.

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Acknowledgements

We thank the PRAMS Working Group (Alabama—Danita Crear, DrPH; Alaska—Kathy Perham-Hester, MS, MPH; Arkansas— Mary McGehee, PhD; Colorado—Alyson Shupe, PhD; Connecticut—Jennifer Morin, MPH; Delaware— George Yocher, MS; District of Columbia—Pamela Oandasan; Florida— Jerri Foreman, MPH; Georgia— Jenna Self, MPH; Hawaii— Emily Roberson, MPH; Illinois—Theresa Sandidge, MA; Indiana—Jenny Durica, MPH; Iowa —Sarah Mauch, MPH; Louisiana— Jane Herwehe, MPH; Maine—Tom Patenaude, MPH; Maryland—Diana Cheng, MD; Massachusetts— Emily Lu, MPH; Michigan— Cristin Larder, MS; Minnesota—Judy Punyko, PhD, MPH; Mississippi— Brenda Hughes, MPPA; Missouri—Venkata Garikapaty, MSc, MS, PhD, MPH; Montana—JoAnn Dotson; Nebraska—Brenda Coufal; New Hampshire—Paulette Valliere, MPH; New Jersey—Lakota Kruse, MD; New Mexico—Eirian Coronado, MPH; New York State—Anne Radigan-Garcia; New York City—Candace Mulready-Ward, MPH; North Carolina— Kathleen Jones-Vessey, MS; North Dakota—Sandra Anseth; Ohio—Connie Geidenberger, PhD; Oklahoma—Alicia Lincoln, MSW, MSPH; Oregon—Kenneth Rosenberg, MD, MPH; Pennsylvania—Tony Norwood; Rhode Island—Sam Viner-Brown, PhD; South Carolina—Mike Smith, MSPH; Tennessee—Angela Miller, PhD, MSPH; Texas— Rochelle Kingsley, MPH; Utah—Lynsey Gammon, MPH; Vermont—Peggy Brozicevic; Virginia—Marilyn Wenner; Washington—Linda Lohdefinck; West Virginia—Melissa Baker, MA; Wisconsin—Mireille Perzan, MPH; Wyoming—Amy Spieker, MPH; CDC PRAMS Team, Applied Sciences Branch, Division of Reproductive Health).

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. School of Public Health, Brown University, Providence, RI, USA

    Shuai Xie & Annie Gjelsvik

  2. Rhode Island Department of Health, Providence, RI, USA

    Karine Monteiro

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  1. Shuai Xie
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SX: project development, manuscript writing, and data analysis. AG: project development, manuscript editing, and review. KM: manuscript review.

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Correspondence to Shuai Xie.

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Xie, S., Monteiro, K. & Gjelsvik, A. Influenza vaccine during pregnancy, recommendations from healthcare providers, and race/ethnicity in the United States. Arch Gynecol Obstet (2024). https://doi.org/10.1007/s00404-023-07366-1

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