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Q&A

Infectious Diseases

Poster Session 1

(265) Patient-level trends in vaccine uptake during the COVID pandemic

Tuesday, February 13, 2024

10:30 AM – 12:00 PM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Primary & Presenting Author(s)

Ravyn Njagu, MD

Duke University
Durham, NC, United States

Coauthor(s)

AB

Amanda Brucker, PhD

Duke University School of Medicine
Durham, NC, United States
KF

Kelvin Feng, N/A

Duke University School of Medicine
Durham, NC, United States
SL

Siera Lunn, BS

Duke University School of Medicine
Durham, NC, United States
MG

Melissa Greene, BS

Duke University School of Medicine
Durham, NC, United States
Geeta K. Swamy, MD

Associate Professor, Duke ObGyn and Associate Vice President for Research and Vice Dean for Scientific Integrity
Duke University
Durham, NC, United States
Sarah K. Dotters-Katz, MD

Associate Professor
Duke University Medical Center
Durham, NC, United States

Objective: Influenza and tetanus toxoid reduced diphtheria toxoid, acellular pertussis(TDaP) vaccines are safe, effective, and recommended in pregnancy. Despite this, significant vaccine hesitancy exists in pregnancy. The impact of the COVID-19 pandemic on vaccine hesitancy is not well understood. We describe impact of the COVID-19 pandemic on patient-level influenza, TDaP, and dual vaccination trends.

Study Design: Retrospective cohort study of patients delivering at single academic center with pregnancies in both pre-COVID(10/1/17-8/31/19) and mid-COVID(10/1/20-8/31/21) periods. Demographic and vaccine data abstracted. Primary outcome was change in vaccine choice between epochs. Generalized estimating equations repeated measures framework used to model changes in patient vaccine choices comparing across race/ethnicity. Analyses adjusted for payor, maternal age, and gestational age, calculating odds ratios and 95% confidence intervals.

Results: Of 420 patients with at least one pregnancy in both periods, 49.8% were NH white, 28.4% NH black, and 14.9% Hispanic. Across all vaccines, the majority of patients had consistent vaccination preferences across both periods. 315/420(75%) the same flu vaccination preference, 353/420(84%) the same TDaP preference, and 242/420(58%) received both vaccinations(Figure). However, NH Black patients had significantly lower odds of flu vaccination mid-COVID vs pre-COVID (aOR: 0.60, 95%CI:0.38, 0.95). NH White patients had significant increase in receiving both vaccinations mid-COVID (aOR:1.61, 95%CI:1.03, 2.53).

Conclusion: Majority of vaccination decisions remained consistent despite the pandemic. However, in response to the pandemic NH black patients were less likely to receive influenza vaccination while NH white patients were more likely to receive dual vaccination. These data emphasize the importance of continued counseling and education efforts to better understand societal and cultural norms that impact patient hesitancy during pandemic-mediated prenatal care.