Influenza and pertussis vaccination of women during pregnancy in Victoria, 2015–2017
Stacey L Rowe, Kirsten P Perrett, Rosemary Morey, Nicola Stephens, Benjamin C Cowie, Terry M Nolan, Karin Leder, Helen Pitcher, Brett Sutton, Allen C Cheng. Medical Journal of Australia 2019; 201(10): 454–462. DOI: 10.5694/mja2.50125
The known: Influenza and pertussis vaccinations during pregnancy are safe, and effectively prevent infections in women and their infants.
The new: Pertussis vaccination of pregnant women in Victoria increased during 2015–17 from 38% to 82%. The overall rate of influenza vaccination was 39%, but the level varied by season. Individual and hospital‐level factors contributed to variations in uptake, including lower rates among overseas‐born women, women who smoked during pregnancy, and Aboriginal and Torres Strait Islander Australian women.
The implications: Structural changes at the system level may improve maternal vaccination rates. Embedding the delivery of vaccinations in antenatal care pathways should be a priority.
Objectives – To assess variations by time of year and hospital in the uptake of influenza and pertussis vaccinations by pregnant women in Victoria; to identify factors associated with vaccination uptake.
Design, setting – Retrospective analysis of data in the Victorian Perinatal Data Collection (VPDC), a population surveillance system for obstetric conditions, procedures, and pregnancy and birth outcomes.
Participants – Women whose pregnancies ended in a live or stillbirth during July 2015 – June 2017.
Main outcome measures – Influenza and pertussis vaccinations during pregnancy.
Results – 153 980 pregnancies in 67 hospitals ended during July 2015 – June 2017; 59 968 pregnant women (39.0%) were vaccinated against influenza and 98 583 (64.0%) against pertussis. Coverage varied by pregnancy end date, rising for influenza during winter and spring, but for pertussis rising continuously across the two years from 37.5% to 82.2%. Differences between hospitals in coverage were marked. Factors associated with vaccination included greater maternal age, primigravidity, early antenatal care, and GP‐led care. The odds of vaccination were statistically significantly lower for women born overseas and those who smoked during pregnancy; the odds of vaccination were also lower for Aboriginal and Torres Strait Islander women.
Conclusions – Pertussis vaccination of pregnant women in Victoria has increased, but influenza vaccination rates remain moderate and variable. Structural changes at the system level may improve maternal vaccination rates. Embedding the delivery of maternal vaccination programs in antenatal care pathways should be a priority.