Journal Article

Trend and factors associated to pertussis and influenza vaccination in pregnant women in Madrid, Spain, 2018–2023 – a retrospective cohort study

López-Zambrano, María Alejandra, Gutierrez Rodríguez, María Ángeles, Cañellas Llabrés, Soledad, Vazquez Torres, María, Molina Olivas, Marta, Sánchez-Gómez, Amaya, Lasheras Carbajo, María Dolores

2025

Overview

Vaccination of pregnant women (PW) is an essential public health measure with benefits for both mothers and newborns. Vaccination against seasonal influenza and pertussis have been recommended in Spain for almost a decade; however, the adherence to this recommendation is variable. The objective of this study was to assess pertussis vaccination coverage (PVC) and influenza vaccination coverage (IVC) among PW in the region of Madrid, Spain, and to explore the factors associated with vaccination. We conducted a retrospective cohort study using administrative registries. For PVC 197,984 PW who gave birth between 2019 and 2022 were included in the study. For IVC, 182,014 PW target of the 2018–19 to 2022–23 seasonal influenza campaigns were included. Generalized estimating equations were used to estimate factors associated with vaccination. The global VC in PW was 87.0 % for pertussis and 53.2 % for influenza. A peak was observed coinciding with the start of COVID-19 vaccination. Factors associated with lower probability of being vaccinated were mother born in a foreign country (Pertussis: aOR:0.73 (95 %CI:0.71–0.76); Influenza: aOR:0.71 (95 %CI:0.69–0.73)), enrolment in public healthcare insurance in last stages or after delivery (Pertussis: aOR:0.04 (95 %CI:0.04–0.05); Influenza: aOR:0.09 (95 %CI:0.08–0.11)) and home births (Pertussis: aOR:0.11 (95 %CI:0.08–0.16); Influenza: aOR:0.22 (95 %CI:0.15–0.31)). PW aged between 30 and 39 years old, with full term pregnancies, who live in areas with middle net incomes and have at least one chronic condition with indication for vaccination were more likely to be vaccinated. Significant challenges remain to improve vaccination uptake in PW, particularly concerning influenza. These findings may prove useful to tailor strategies to reach specific subgroups within the PW population. •Vaccination in pregnancy reduces disease burden in women and their infants.•In Madrid, Spain, vaccine coverage is lower for influenza than for whooping cough.•Vaccination uptake has decreased since COVID-19 pandemic.•Foreign, lower-income and adolescent women are less likely to get vaccinated.•Potential inequalities in maternal immunization coverage should be addressed.

• Publisher: Elsevier Ltd,Elsevier Limited
• Subject: Adult / Allergy and Immunology / Binomial distribution / Censuses / Cohort analysis / Congenital diseases / Country of birth / COVID-19 / Female / Humans / Immunity (Disease) / Income distribution / Influenza / Influenza vaccination / Influenza Vaccines - administration & dosage / Influenza, Human - epidemiology / Influenza, Human - prevention & control / Information systems / Multivariate analysis / Neonates / Newborn babies / Pertussis / Pertussis vaccination / Pertussis Vaccine - administration & dosage / Population / Pregnancy / Pregnancy Complications, Infectious - prevention & control / Pregnant People / Pregnant women / Premature birth / Primary care / Public health / Regression analysis / Retrospective Studies / Sociodemographics / Spain / Spain - epidemiology / Subgroups / Vaccination / Vaccination - statistics & numerical data / Vaccination - trends / Vaccination coverage / Vaccination Coverage - statistics & numerical data / Vaccination Coverage - trends / Vaccines / Variables / Whooping cough / Whooping Cough - epidemiology / Whooping Cough - prevention & control / Womens health / Young Adult