scholarly journals Individual and Neighborhood Factors Associated With Failure to Vaccinate Against Influenza During Pregnancy

2020 ◽  
Vol 189 (11) ◽  
pp. 1379-1388
Author(s):  
Ousseny Zerbo ◽  
G Thomas Ray ◽  
Lea Zhang ◽  
Kristin Goddard ◽  
Bruce Fireman ◽  
...  
Keyword(s):  
Black Women ◽  
Influenza Vaccine ◽  
Pregnant Women ◽  
Vaccine Coverage ◽  
Sociodemographic Factors ◽  
Kaiser Permanente ◽  
Factors Associated ◽  
High Deprivation ◽  
High Prevalence ◽  
Fourth Quartile

Abstract Uptake of influenza vaccine among pregnant women remains low. We investigated whether unvaccinated pregnant women were clustered geographically and determined factors associated with failure to vaccinate using spatial and multivariate logistic regression analyses. Pregnant women who were members of Kaiser Permanente Northern California in 2015 or 2016 were included in the study. More than half (53%) of the 77,607 included pregnant women were unvaccinated. Spatial analysis identified 5 clusters with a high prevalence of unvaccinated pregnant women. The proportion of unvaccinated women ranged from 57% to 75% within clusters as compared with 51% outside clusters. In covariate-adjusted analyses, residence in a cluster was associated with a 41% increase in the odds of being unvaccinated (odds ratio (OR) = 1.41, 95% confidence interval (CI): 1.36, 1.46). The odds of being unvaccinated were greater for Black women (OR = 1.58, 95% CI: 1.49, 1.69), Hispanic women (OR = 1.15, 95% CI: 1.05, 1.25), women with subsidized health insurance (OR = 1.18, 95% CI: 1.11, 1.24), women with fewer than 5 prenatal-care visits (OR = 1.85, 95% CI: 1.60, 2.16), and neighborhoods with a high deprivation index (fourth quartile vs. first: OR = 1.14, 95% CI: 1.07, 1.21). In conclusion, unvaccinated pregnant women were clustered geographically and by key sociodemographic factors. These findings suggest that interventions to increase influenza vaccine coverage among pregnant women are needed, particularly in vulnerable populations.

scholarly journals Trajectories of Depressive Symptoms and Anxiety during Pregnancy and Associations with Pregnancy Stress

2021 ◽  
Vol 18 (5) ◽  
pp. 2733 ◽  
Author(s):  
Hyejung Lee ◽  
Ki-Eun Kim ◽  
Mi-Young Kim ◽  
Chang Gi Park ◽  
Jung Yeol Han ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Pregnant Women ◽  
Healthcare Providers ◽  
Sociodemographic Factors ◽  
Survey Questionnaire ◽  
Emotional Status ◽  
Factors Associated ◽  
Latent Trajectory ◽  
Logistic Regressions ◽  
Health Hospital

The purposes of this study were to investigate the trajectory groups of depressive symptoms and anxiety in women during pregnancy and to identify the factors associated with those groups. Participants were recruited from the outpatient clinic of a women’s health hospital in Seoul, Korea. Pregnant women (n = 136) completed a survey questionnaire that included questions on depressive symptoms, anxiety, and pregnancy stress; additionally, their saliva was tested for cortisol hormone levels three times during their pregnancies. The group-based trajectory modeling approach was used to identify latent trajectory groups. Ordinal logistic regressions were used to explore the association of latent trajectory groups with sociodemographic factors and pregnancy stress. Three trajectory groups of depressive symptoms were identified: low-stable (70%), moderate-stable (25%), and increased (5%). Four trajectory groups of anxiety were identified: very low-stable (10%), low-stable (67%), moderate-stable (18%), and high-stable (5%). The only factor associated with both the depressive symptoms and anxiety trajectory groups was pregnancy stress (p < 0.001). Most participants showed stable emotional status; however, some participants experienced higher levels of depressive symptoms and anxiety related to higher pregnancy stress. These pregnant women may need additional care from healthcare providers to promote their wellbeing during pregnancy.

scholarly journals Factors associated with childhood influenza vaccination in Israel: a cross-sectional evaluation

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Aharona Glatman-Freedman ◽  
Kanar Amir ◽  
Rita Dichtiar ◽  
Hila Zadka ◽  
Ifat Vainer ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Vaccine Coverage ◽  
Population Group ◽  
Vaccine Uptake ◽  
Arab Population ◽  
Cross Sectional ◽  
Vaccine Acceptance ◽  
Factors Associated ◽  
Beneficial Effects

Abstract Background Vaccinating children against influenza has shown both direct and indirect beneficial effects. However, despite being offered free of charge, childhood influenza vaccine coverage in Israel has been low. Our objective was to evaluate the factors associated with childhood influenza vaccination in Israel. Methods A cross-sectional language-specific telephone survey was conducted among adults 18 years or older, to examine childhood influenza vaccination practices and their associations with socio-demographic and relevant health variables. We further explored the reasons for these practices among parents. Multivariate logistic regression was used to identify factors associated with childhood influenza vaccine acceptance. Results Of a total of 6518 individuals contacted by mobile phone, 1165 eligible parents, ≥18 years old with children 1–18 years of age, were interviewed, and 1040 of them completed the survey successfully. Overall, factors associated with childhood influenza vaccination were younger child’s age, influenza vaccination of other family members and belonging to the Arab population group. No association was found between childhood influenza vaccination and routine childhood vaccine uptake. Several of the parents’ reasons for vaccine acceptance - preventing influenza or its transmission, awareness regarding the need for influenza vaccination and receipt of invitation to get vaccinated - differed significantly between Jewish and Arab parents. Several reasons reported by parents for not vaccinating children against influenza, indicated a likelihood to accept influenza vaccine outreach efforts. Such reasons were reported by 27.5% of Jewish parents and 37.5% of Arab parents. Conclusions We found that certain demographic factors were associated with childhood influenza vaccination in Israel. Several reasons described by the parent for not vaccinating their children indicate that outreach efforts are likely to increase childhood influenza vaccination. Addressing population group-specific needs is recommended to optimize the success of influenza vaccine outreach efforts.

scholarly journals Prevalence of Anemia Across Trimesters in Multiethnic Pregnant Women

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 765-765
Author(s):  
Wanhui Kang ◽  
Carrie Irvine ◽  
Eva Pressman ◽  
Kimberly O'Brien
Keyword(s):  
Risk Factors ◽  
Black Women ◽  
Pregnant Women ◽  
White Women ◽  
Late Gestation ◽  
Racial Groups ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
T1 And T2 ◽  
Prevalence Of Anemia

Abstract Objectives This study aimed to characterize prevalence and determinants of anemia in a multiethnic cohort of pregnant women. Methods A retrospective medical chart review was undertaken of all deliveries occurring from 2011 to 2020 at Strong Memorial Hospital and Highland Hospital in Rochester, NY. Among a total of 53,642 deliveries, 42,289 occurred to women with no underlying health complications. Anemia was defined using the CDC criteria as &lt; 11g/dL in the first (T1) and third trimesters (T3) and &lt; 10.5 g/dL in the second trimester (T2). Mean Hb concentration was compared between trimesters and racial groups by ANOVA and post-hoc pairwise comparisons. Relationships between prevalence of anemia by trimesters, racial groups, and BMI were examined by chi-square or t-tests. Logistic regression models were conducted to estimate the risk factors associated with anemia. Results Pregnant women had a mean age of 29.8 ± 5.5 y (range: 13−52 y) at delivery. The majority of women (66.8%) self-identified as white, 20.0% as black, 3.8% as Asian, and 9.4% as Other. Mean Hb concentrations significantly differed by trimester [12.6 ± 1.0, 11.5 ± 1.1, and 11.8 ± 1.3 g/dL in T1, T2 and T3, respectively, p &lt; 0.001]. Mean Hb was significantly lower in black women in each trimester by -0.8 (T1), -0.7 (T2), and -1.0 g/dL (T3) compared to white women. White women had the highest Hb concentrations in T1 and T2 (12.8 ± 0.9, 11.8 ± 1.0 g/dL) while Asian women had the highest Hb concentrations in T3 (12.2 ± 1.2 g/dL, n = 1577, p &lt; 0.001). The overall prevalence of anemia was 17.1%, which significantly increased across pregnancy [4.5% (T1), 16.4% (T2) and 25.2% (T3), p &lt; 0.001]. Observed rates of anemia were higher than the estimated NHANES (1999–2006) prevalence in pregnant women. After stratifying by racial groups, higher BMI was significantly associated with a lower prevalence of anemia in T2 and T3 only in black women and in those whose race was categorized as Other. Conclusions The prevalence of anemia was highest in black pregnant women in all trimesters, while it was lowest in white pregnant women in T1 and T2, and in Asians in T3. Risk factors associated with anemia included late gestation or self-reported race as black or Other. Funding Sources None.

Correlates of Seasonal Influenza Vaccine Coverage Among Pregnant Women in Georgia and Rhode Island

2010 ◽  
Vol 116 (4) ◽  
pp. 949-955 ◽  
Author(s):  
Indu B. Ahluwalia ◽  
Denise J. Jamieson ◽  
Sonja A. Rasmussen ◽  
Denise DʼAngelo ◽  
David Goodman ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Pregnant Women ◽  
Rhode Island ◽  
Seasonal Influenza ◽  
Vaccine Coverage ◽  
Seasonal Influenza Vaccine

scholarly journals 19. Completion of Two-Dose Recombinant Zoster Vaccine Series in Adults 50 Years and Older

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S32-S33
Author(s):  
Hung-Fu Tseng ◽  
Lei Qian ◽  
Jun Wu ◽  
Yi Luo ◽  
Lina S Sy ◽  
...  
Keyword(s):  
Health Care ◽  
Influenza Vaccine ◽  
Zoster Vaccine ◽  
Kaiser Permanente ◽  
Factors Associated ◽  
Series Completion ◽  
Race Ethnicity ◽  
Recombinant Zoster Vaccine ◽  
Research Grant

Abstract Background In 2017, the Advisory Committee on Immunization Practices preferentially recommended adjuvanted recombinant zoster vaccine (RZV) for adults ≥ 50 years as a two-dose series 2–6 months apart.1 We evaluated two-dose RZV completion and factors associated with completion. Methods The study included Kaiser Permanente Southern California members ≥ 50 years who received an RZV dose during April-November 2018 and had continuous membership 12 months before to 9 months after the 1st RZV dose (RZV1). Completion was defined as receipt of the 2nd dose ≥4 weeks to 9 months after RZV1 (allowing a 3-month grace period). Characteristics including age at RZV1, sex, race/ethnicity, Medicaid status, neighborhood level income and education, distance from home to medical office, comorbidities, history of herpes zoster, health care utilization before and after RZV1, receipt of influenza vaccine, vaccination month (supply shortage proxy), concomitant vaccine, department administering RZV1, medical center, and medically attended local or systemic reaction, pain, or gout after RZV1 were compared between completers and non-completers. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) for factors associated with completion were estimated by multivariable logistic regression. Results Among 31,120 RZV1 recipients, 67.2% completed the series within 9 months. In adjusted analyses, higher completion was associated with White compared with Black or Hispanic race/ethnicity, higher neighborhood income and education, no chronic pulmonary disease, diabetes, or dementia, more outpatient visits and fewer emergency department visits before or after RZV1, no hospitalizations after RZV1, receipt of influenza vaccine, receipt of RZV1 in June-November rather than April-May 2018, no concomitant vaccine with RZV1, and receipt of RZV1 in Family Practice rather than Internal Medicine. Systemic reactions or pain after RZV1 was not associated with completion. Table 2. RZV Series Completion by Selected Characteristics During Follow-up of Members Aged ≥50 Years Who Received at Least One Dose of RZV at Kaiser Permanente Southern California in April-November 2018 Table 2. RZV Series Completion by Selected Characteristics During Follow-up of Members Aged ≥ 50 Years Who Received at Least One Dose of RZV at KPSC in April-November 2018 Figure 1. Factors Associated with RZV Series Completion of Members Aged ≥ 50 Years Who Received at Least One Dose of RZV at KPSC in April-November 2018 Conclusion Completion of RZV series appears moderate in the early phase of implementation. Despite similar accessibility in a health care system, completion varied by race/ethnicity, socioeconomic status, health status, and care seeking behavior, suggesting areas to target for improvement. Disclosures Hung-Fu Tseng, MPH, PhD, GlaxoSmithKlein (Research Grant or Support) Lei Qian, PhD, GlaxoSmithKlein (Research Grant or Support) Jun Wu, MD, MS, GlaxoSmithKlein (Research Grant or Support) Yi Luo, PhD, GlaxoSmithKlein (Research Grant or Support) Lina S. Sy, MPH, GlaxoSmithKlein (Research Grant or Support) Katia Bruxvoort, PhD, MPH, GlaxoSmithKlein (Research Grant or Support) Bradley Ackerson, MD, GlasoSmithKlein (Research Grant or Support)

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