Social determinants of health and vaccine uptake in pregnancy: Disparities in a diverse, predominately foreign-born population

Vaccine. 2024 Jan 25;42(3):529-534. doi: 10.1016/j.vaccine.2023.12.069. Epub 2024 Jan 3.

Abstract

Objective: To identify discrepancies in influenza, Tdap, and COVID-19 vaccine uptake and offer rates among pregnant individuals across various social determinants of health including race, ethnicity, foreign-born status, education level, and health insurance coverage, highlighting potential interventions to improve vaccine uptake in pregnancy.

Methods: An IRB-approved cross-sectional survey was conducted on the postpartum floor of a large urban hospital in South Florida. Between July to September 2021, 359 participants consented and answered questions on their demographics, social background, and influenza, Tdap, and COVID-19 vaccine history.

Results: Most participants identified as White (67.7 %), Hispanic (67.4 %), and foreign-born (68.5 %) with an average age of 29.7 ± 6 years. There was a significant difference in mean vaccine between White (1.3) and Black individuals (0.9, p = 0.002). Mean uptake was significantly higher in foreign-born individuals (1.3) compared to US-born (0.9, p < 0.001). Mean uptake was significantly higher for those with graduate (1.7) and college (1.4) degrees compared to those with a high school degree (1.0) or less than high school (1.0, p < 0.0001).

Conclusion: Significant differences in the uptake and offer rates of influenza, Tdap, and COVID-19 vaccines were observed across a variety of social determinants including educational attainment, employment, insurance, and median income of the zip code of primary residence.

Keywords: COVID-19; Influenza; Maternal immunization; Pregnant; Tdap; Vaccination.

MeSH terms

  • Adult
  • Bacterial Vaccines
  • COVID-19 Vaccines
  • Cross-Sectional Studies
  • Female
  • Humans
  • Influenza Vaccines*
  • Influenza, Human* / prevention & control
  • Pregnancy
  • Social Determinants of Health
  • Vaccination
  • Young Adult

Substances

  • COVID-19 Vaccines
  • Influenza Vaccines
  • Bacterial Vaccines