Effects of the COVID-19 Pandemic on Routine Maternal Vaccine Uptake [A176]

INTRODUCTION: This study examines the impact of the COVID-19 pandemic on influenza and Tdap (tetanus, diphtheria, pertussis) vaccine uptake in a pregnant, low-income population. METHODS: This retrospective cohort study included women initiating prenatal care before (May–November 2019) or during the COVID-19 pandemic (May–November 2020) at two large Medicaid clinics. All patients entered prenatal care before 20 weeks of gestation and delivered full-term. Medical records were reviewed for vaccine uptake and demographic data. Multivariate logistic regression analysis was used to compare vaccination rates prior to and during the COVID-19 pandemic. Additional analysis was performed to identify association of demographic factors with vaccine uptake. Institutional review board‒ approval was obtained for this study. RESULTS: A total of 939 patients were included, with 462 initiating care prior to and 477 initiating care during the COVID-19 pandemic. Influenza vaccination uptake was 78% (362/462) in the pre-pandemic group, significantly decreasing to 61% (291/477) in the pandemic group ( P <.01; OR, 0.38; 95% CI, 0.26–0.53). Tdap vaccination uptake was 85% (392/462) in the pre-pandemic group, significantly decreasing to 76% (361/477) in the pandemic group ( P <.01; OR, 0.56; 95% CI, 0.40–0.79). Unvaccinated patients were significantly more likely to be non-Hispanic Black patients when compared to Hispanic patients both pre-pandemic ( P <.01; OR, 0.34; 95% CI, 0.21–0.56) and during the pandemic ( P <.01; OR, 0.24; 95% CI, 0.15–0.38), while there was no significant difference in age or parity in relation to vaccination status. CONCLUSION: Routine vaccination uptake significantly decreased during the COVID-19 pandemic in a low-income population of pregnant women, with decrease more pronounced on influenza vaccine than on Tdap vaccine uptake.