加拿大安大略省 2019 年至 2022 年孕期 SARS-CoV-2、百白破和流感疫苗接种情况:一项基于人群的回顾性队列研究。

IF 9.4 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Devon Greyson, Rebecca Correia, Michelle Howard, Elizabeth K Darling, David Kirkwood, Amie Davis, Caroline Mniszak, Aaron Jones, Monica Molinaro, Meredith Vanstone
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引用次数: 0

摘要

背景:怀孕期间对接种疫苗的犹豫不决给 SARS-CoV-2 疫苗接种工作带来了挑战。我们旨在研究 2022 年初分娩的安大略省居民的 SARS-CoV-2 疫苗接种率,并将 SARS-CoV-2 疫苗接种率与 2019 年、2021 年和 2022 年怀孕期间的破伤风、白喉和百日咳 (Tdap) 及流感疫苗接种率进行比较:我们开展了一项基于人群的回顾性队列研究,利用关联的管理数据来描述安大略省怀孕人群和同类非怀孕人群的疫苗接种率。2019年、2021年或2022年1月1日至3月31日期间在医院内分娩的省保险女性是我们的主要队列。我们使用对数二项式回归法检验了 SARS-CoV-2 (2022 年)与百白破疫苗和流感疫苗(2019 年、2021 年、2022 年)接种情况之间的关系,以及出生组别和协变量。我们将 SARS-CoV-2 疫苗接种情况与匹配的非孕妇群的接种情况进行了比较,并按年龄和产前临床医生类型进行了亚组分析:在分娩人群中,78.7% 接种了第一剂 SARS-CoV-2 疫苗,74.2% 接种了第二剂。非孕妇的接种率明显更高(第一剂:相对风险 [RR]0.94,95% 置信区间 [CI]0.93-0.94;第二剂:RR 0.91,95% 置信区间 [CI]0.90-0.91)。不过,分娩人群中接种 SARS-CoV-2 疫苗的比例高于接种百白破疫苗或流感疫苗的比例。随着时间的推移,破伤风、白喉和百日咳疫苗接种率从 2019 年的 22.2% 上升到 2022 年的 32.6%,流感疫苗接种率在 2021 年上升到 35.3%,但在 2022 年又回到了流行前的水平(27.7%)。年轻孕妇、多胎妊娠者、农村居民或经济贫困地区居民的三种疫苗接种率都较低:SARS-CoV-2疫苗在孕妇中的接种率低于在非孕妇中的接种率,但高于常规推荐的百白破疫苗和流感疫苗的接种率。大流行的紧迫性可能克服了人们对 2022 年孕期接种 SARS-CoV-2 疫苗的犹豫不决,但孕期常规推荐疫苗的接种率仍然是一个挑战:试验注册:Clinicaltrials.gov, no.试验注册:Clinicaltrials.gov,编号:NCT05663762。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
SARS-CoV-2, Tdap, and influenza vaccination during pregnancy from 2019 to 2022 in Ontario, Canada: a population-based retrospective cohort study.

Background: Hesitancy about vaccination during pregnancy posed challenges to SARS-CoV-2 vaccination efforts. We aimed to examine rates of SARS-CoV-2 vaccination among Ontario residents who gave birth in early 2022, and to compare rates of SARS-CoV-2 vaccine uptake with rates of tetanus, diphtheria, and pertussis (Tdap) and influenza vaccination during pregnancy in 2019, 2021, and 2022.

Methods: We conducted a population-based retrospective cohort study to describe vaccination rates among pregnant and comparable nonpregnant populations in Ontario using linked administrative data. Provincially insured females who had a live, in-hospital birth from Jan. 1 to Mar. 31 in 2019, 2021, or 2022 were our primary cohort. Using log-binomial regression, we tested associations between SARS-CoV-2 (2022) and Tdap and influenza (2019, 2021, 2022) vaccination status, with birth group and covariates. We compared SARS-CoV-2 vaccination status with the status of a matched cohort of nonpregnant females and conducted subgroup analyses by age and prenatal clinician type.

Results: Among birthing people, 78.7% received their first SARS-CoV-2 vaccine dose and 74.2% received a second dose. The rate was significantly higher among nonpregnant comparators (dose 1: relative risk [RR] 0.94, 95% confidence interval [CI] 0.93-0.94; dose 2: RR 0.91, 95% CI 0.90-0.91). However, the rate of SARS-CoV-2 vaccination uptake among birthing people was higher than uptake of Tdap or influenza vaccination. Tetanus, diphtheria, and pertussis vaccination increased over time from 22.2% in 2019 to 32.6% in 2022, and influenza vaccination rose to 35.3% in 2021 but returned to prepandemic levels in 2022 (27.7%). Vaccination rates were lower among pregnant people who were young, multiparous, or residents of rural or economically deprived areas for all 3 vaccines.

Interpretation: Rates of SARS-CoV-2 vaccination were lower among pregnant people than among nonpregnant comparators but were higher than rates of routinely recommended Tdap and influenza vaccinations. Pandemic urgency may have overcome a great deal of hesitancy about vaccinating against SARS-CoV-2 during pregnancy in 2022, but uptake of routinely recommended vaccines in pregnancy remains a challenge.

Trial registration: Clinicaltrials.gov, no. NCT05663762.

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来源期刊
Canadian Medical Association journal
Canadian Medical Association journal 医学-医学:内科
CiteScore
8.30
自引率
4.10%
发文量
481
审稿时长
4-8 weeks
期刊介绍: CMAJ (Canadian Medical Association Journal) is a peer-reviewed general medical journal renowned for publishing original research, commentaries, analyses, reviews, clinical practice updates, and editorials. Led by Editor-in-Chief Dr. Kirsten Patrick, it has a significant impact on healthcare in Canada and globally, with a 2022 impact factor of 17.4. Its mission is to promote knowledge vital for the health of Canadians and the global community, guided by values of service, evidence, and integrity. The journal's vision emphasizes the importance of the best evidence, practice, and health outcomes. CMAJ covers a broad range of topics, focusing on contributing to the evidence base, influencing clinical practice, and raising awareness of pressing health issues among policymakers and the public. Since 2020, with the appointment of a Lead of Patient Involvement, CMAJ is committed to integrating patients into its governance and operations, encouraging their content submissions.
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