• Lauren D Arnold, Lan Luong, Terri Rebmann, and Jen Jen Chang.
• Department of Epidemiology & Biostatistics, College for Public Health & Social Justice, Saint Louis University, 3545 Lafayette Ave, St. Louis, MO 63104, USA. Electronic address: lauren.arnold@slu.edu.
• Vaccine. 2019 Apr 24; 37 (18): 2520-2526.

BackgroundPregnant women are at increased risk of hospitalization, serious complications, poor pregnancy outcomes, and mortality from influenza. Prior research suggests that there are racial/ethnic disparities in vaccination coverage and that a healthcare provider vaccination recommendation is associated with significantly higher vaccine uptake than without such a recommendation. The purpose of this study is to examine racial/ethnic disparities in healthcare providers' recommendations for pregnant women to receive the influenza vaccine and in vaccine uptake.MethodsThis cross-sectional population-based study analyzed data from the Centers for Disease Control and Prevention's Pregnancy Risk Assessment Monitoring System (PRAMS) during 2012-2015 (n = 130161). Both healthcare provider recommendation and vaccine uptake were assessed dichotomously. Logistic regression was conducted to ascertain adjusted odds ratios and 95% confidence intervals, controlling for maternal age, marital status, education, prenatal care utilization, and smoking status.ResultsInfluenza vaccine uptake during pregnancy ranged from 39.1% among non-Hispanic (NH) Black women to 55.4% among NH Asian women. In the adjusted analysis, NH Black and NH Asian women had 19% (95% CI 0.75-0.86) and 34% (95% CI 0.61-0.72) decreased odds of receiving a provider recommendation for influenza vaccine during pregnancy, respectively, compared to NH White women. For influenza vaccine uptake, NH Black women were 30% less likely (95% CI 0.65-0.74) to receive influenza vaccine during pregnancy compared to NH White women.ConclusionsOur findings indicate that there are racial/ethnic disparities in healthcare provider recommendation and influenza vaccine uptake among pregnant women in the United States. Targeted efforts toward providers and interventions focusing on pregnant women may be warranted to reduce the disparity.Copyright © 2019 Elsevier Ltd. All rights reserved.

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