• Thomas Woodcock, Vesselin Novov, Helen Skirrow, James Butler, Derryn Lovett, Yewande Adeleke, Mitch Blair, Sonia Saxena, Azeem Majeed, and Paul Aylin.
• Department of Primary Care and Public Health, Imperial College London, London.
• Br J Gen Pract. 2023 Feb 1; 73 (727): e148e155e148-e155.

BackgroundPregnant women are at increased risk from influenza, yet maternal influenza vaccination levels remain suboptimal.AimTo estimate associations between sociodemographic and health characteristics and seasonal influenza vaccination uptake among pregnant women, and to understand trends over time to inform interventions to improve vaccine coverage.Design And SettingRetrospective cohort study using linked electronic health records of women in North West London with a pregnancy overlapping an influenza season between September 2010 and February 2020.MethodA multivariable mixed-effects logistic regression model was used to identify associations between characteristics of interest and the primary outcome of influenza vaccination.ResultsIn total, 451 954 pregnancies, among 260 744 women, were included. In 85 376 (18.9%) pregnancies women were vaccinated against seasonal influenza. Uptake increased from 8.4% in 2010/11 to 26.4% in 2017/18, dropping again to 21.1% in 2019/20. Uptake was lowest among women aged 15-19 years (11.9%; reference category) or ≥40 years (15.2%; odds ratio [OR] 1.17, 95% confidence interval [CI] = 1.10 to 1.24); of Black (14.1%; OR 0.55, 95% CI = 0.53 to 0.57) or unknown ethnicity (9.9%; OR 0.42, 95% CI = 0.39 to 0.46); who lived in more deprived areas (OR least versus most deprived [reference category] 1.16, 95% CI = 1.11 to 1.21); or with no known risk factors for severe influenza.ConclusionSeasonal influenza vaccine uptake in pregnant women increased in the decade before the COVID-19 pandemic, but remained suboptimal. Targeted approaches are recommended to reducing inequalities in access to vaccination and should focus on women of Black ethnicity, younger and older women, and women living in deprived areas.© The Authors.

22 keywords...

hide…