Assessment of Racial Disparities in Prenatal Flu Vaccination in the United States
Author(s)
Danielle Nguyen, PharmD1, Nathorn Chaiyakunapruk, PharmD, PhD2;
1University of Utah, PhD student, Salt Lake City, UT, USA, 2University of Utah, Salt Lake City, UT, USA
1University of Utah, PhD student, Salt Lake City, UT, USA, 2University of Utah, Salt Lake City, UT, USA
OBJECTIVES: American College of Obstetricians and Gynecologists (ACOG) and the Advisory Committee on Immunization Practices (ACIP) universally recommend flu vaccine during pregnancy; however, vaccination uptake may vary by race. This study aims to assess prenatal flu vaccination uptake across race in the United States (US).
METHODS: Pregnancy Risk Assessment Monitoring System (PRAMS), a national surveillance system collecting information on maternal behavior in the perinatal period, was used to collect maternal sociodemographic and vaccine uptake information from 2016 to 2022. A weighted analysis correcting for nonresponse and noncoverage bias was performed to estimate vaccination uptake by race. Differences in vaccination uptake by race were evaluated using a chi-square test. A multivariable logistic regression model was used to assess the association between race and vaccination uptake.
RESULTS: A total of 204,538 respondents were included, comprising 59.9% White, 18.7% Black, 10.6% Other/multiple races, 6.7% Asian, 3.6% American Indian/Alaska Native, and 0.5% Hawaiian/Pacific Islander. Prenatal flu vaccination uptake was 62.0% for White (95% confidence interval (CI) 61.6%-62.4%), 74.2% for Asian (95% CI 73.0%-75.3%), 66.0% for American Indian (63.7%-68.3%), 64.7% for Hawaiian/Pacific Islander (95% CI 58.7%-70.1%), 61.6% for other/multiple race (95% CI 60.5%-62.7%), and 44.4% for Black (95% CI 43.5%-45.2%). Vaccination uptake varied across racial groups (P < 0.001). After adjusting for income and maternal education, Black respondents had the lowest odds ratio of vaccination (0.58, 95% CI 0.55-0.60) while American Indian/Alaska Native respondents had the highest odds ratio (1.56, 95% CI 1.39-1.75), compared to White respondents.
CONCLUSIONS: These findings demonstrate significant racial disparities in prenatal flu vaccination uptake. Future research should explore these disparities while considering intersectionality, such as examining the impact of social determinants of health in conjunction with race on vaccination behavior.
METHODS: Pregnancy Risk Assessment Monitoring System (PRAMS), a national surveillance system collecting information on maternal behavior in the perinatal period, was used to collect maternal sociodemographic and vaccine uptake information from 2016 to 2022. A weighted analysis correcting for nonresponse and noncoverage bias was performed to estimate vaccination uptake by race. Differences in vaccination uptake by race were evaluated using a chi-square test. A multivariable logistic regression model was used to assess the association between race and vaccination uptake.
RESULTS: A total of 204,538 respondents were included, comprising 59.9% White, 18.7% Black, 10.6% Other/multiple races, 6.7% Asian, 3.6% American Indian/Alaska Native, and 0.5% Hawaiian/Pacific Islander. Prenatal flu vaccination uptake was 62.0% for White (95% confidence interval (CI) 61.6%-62.4%), 74.2% for Asian (95% CI 73.0%-75.3%), 66.0% for American Indian (63.7%-68.3%), 64.7% for Hawaiian/Pacific Islander (95% CI 58.7%-70.1%), 61.6% for other/multiple race (95% CI 60.5%-62.7%), and 44.4% for Black (95% CI 43.5%-45.2%). Vaccination uptake varied across racial groups (P < 0.001). After adjusting for income and maternal education, Black respondents had the lowest odds ratio of vaccination (0.58, 95% CI 0.55-0.60) while American Indian/Alaska Native respondents had the highest odds ratio (1.56, 95% CI 1.39-1.75), compared to White respondents.
CONCLUSIONS: These findings demonstrate significant racial disparities in prenatal flu vaccination uptake. Future research should explore these disparities while considering intersectionality, such as examining the impact of social determinants of health in conjunction with race on vaccination behavior.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH127
Topic
Epidemiology & Public Health
Topic Subcategory
Public Health
Disease
STA: Vaccines