Covid-19 and Tdap vaccination among pregnant persons in Ontario, Canada: A population-based retrospective cohort study
Notice bibliographique
Résumé
<h3>Context:</h3> Canadians have historically low rates of vaccination in pregnancy. Although Covid-19 vaccines were recommended for all pregnant persons in Canada, and Ontario prioritized pregnant people for vaccine access in late April 2021, fertility-related misinformation may have compounded the challenge of vaccinating this high-risk population. <h3>Objective:</h3> To examine Covid-19 and pertussis (Tdap) vaccine receipt by pregnant persons during the initial Covid-19 vaccination year. <h3>Study Design and Analysis:</h3> Population-based retrospective cohort study in Ontario, Canada. We used propensity score matching to compare Covid-19 vaccination among pregnant and non-pregnant persons. We examined Tdap across three groups who gave birth in 2019, 2021, and 2022. We developed multivariable linear regression models to control for sociodemographic and clinical factors. <h3>Setting or Dataset:</h3> We linked multiple datasets at ICES, a central administrative data repository, including MOMBABY, Ontario Health Insurance Plan (OHIP), Registered Persons Database (RPDB), COvid-19 vaccine data (COVaxON), and Canadian Index of Multiple Deprivation (CIMD). <h3>Population Studied:</h3> Persons who had a live, in-hospital birth between January 1 to March 31 in 2019, 2021 or 2022. Non-pregnant comparators were females aged 18 to 44 matched 2:1 for parity, geographic area, and age. <h3>Intervention/Instrument:</h3> 2019, 2021, and 2022 births represent giving birth before the pandemic, during COVID-19 but before widespread vaccine availability, and after widespread vaccination. <h3>Outcome Measures:</h3> Covid-19 vaccination records obtained from COVaxON and Tdap status ascertained from physician fee codes in OHIP. <h3>Results:</h3> We identified nearly 30,000 birthing persons in each group. 80.7% of pregnant people who gave birth in early 2022 received Covid-19 dose 1, with 42.4% vaccinated during pregnancy (dose 2: 77.3%; 65.7% during pregnancy). Pregnant persons were significantly less likely to receive Covid-19 vaccines than nonpregnant persons. Tdap vaccination was significantly higher for 2021 and 2022 births compared to 2019. Our multivariable analysis is underway to examine the effects of maternal age, rurality, parity, prenatal care provider type, residential instability, economic dependency, and ethnocultural composition and will be complete in time to share at NAPCRG. <h3>Conclusions:</h3> It appears there was some Covid-19 vaccine hesitancy (refusal or delay) among pregnant people, possibly due to fertility-related misinformation.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».