Increasing Uptake of Maternal Pertussis Vaccinations through Funded Administration in Community Pharmacies
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Study Setting
2.3. Study Population and Sample
2.4. Data Sources
- National Maternity Collection for women using publicly funded maternity/newborn services.
- National Health Index (NHI) number for demographic information.
- National Immunisation Register (NIR) for National Immunisation Schedule vaccinations administered.
- Proclaim for general practice and pharmacy claims for vaccination events.
- DHB Maternity Clinic Data for vaccination events within the hospital.
- Pharmaceutical Collection for community pharmacy dispensing of prescribed medicines.
- Waikato Pharmacy Claims Data for Tdap vaccination of pregnant women.
2.5. Outcomes
2.6. Co-Variates
2.7. Statistical Analysis
3. Results
3.1. Sample
3.2. Pertussis Vaccine Uptake
4. Discussion
4.1. Comparison with Other Literature
4.2. Implications
4.3. Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Total Pertussis Cohort | Pertussis Cohort | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Pre-Intervention Period | Post-Intervention Period | |||||||||
Control Areas | Intervention Area | Control Areas | Intervention Area | |||||||
n | (%) | n | (%) | n | (%) | n | (%) | n | (%) | |
Total | 27,576 | (100.0) | 2905 | (44.8) | 3581 | (55.2) | 9342 | (44.3) | 11,748 | (55.7) |
Maternal age at LMP (years) 2,3 | ||||||||||
12–19 | 1948 | (7.1) | 234 | (8.1) | 239 | (6.7) | 734 | (7.9) | 741 | (6.3) |
20–24 | 5458 | (19.8) | 674 | (23.2) | 760 | (21.2) | 1885 | (20.2) | 2139 | (18.2) |
25–29 | 8268 | (30.0) | 845 | (29.1) | 1079 | (30.1) | 2733 | (29.3) | 3611 | (30.7) |
30–34 | 7498 | (27.2) | 704 | (24.2) | 993 | (27.7) | 2458 | (26.3) | 3343 | (28.5) |
35–39 | 3508 | (12.7) | 359 | (12.4) | 424 | (11.8) | 1208 | (12.9) | 1517 | (12.9) |
40–45 | 869 | (3.2) | 86 | (3.0) | 82 | (2.3) | 315 | (3.4) | 386 | (3.3) |
46+ | 27 | (0.1) | 3 | (0.1) | 4 | (0.1) | 9 | (0.1) | 11 | (0.1) |
Prioritised Ethnicity 2,3 | ||||||||||
Māori | 11,302 | (41.0) | 1534 | (52.8) | 1289 | (36.0) | 4429 | (47.4) | 4050 | (34.5) |
Pacific | 1137 | (4.1) | 114 | (3.9) | 146 | (4.1) | 380 | (4.1) | 497 | (4.2) |
Asian | 2889 | (10.5) | 167 | (5.7) | 430 | (12.0) | 642 | (6.9) | 1650 | (14.0) |
Other | 457 | (1.7) | 31 | (1.1) | 59 | (1.6) | 84 | (0.9) | 283 | (2.4) |
European | 11,791 | (42.8) | 1059 | (36.5) | 1657 | (46.3) | 3807 | (40.8) | 5268 | (44.8) |
Area Level Deprivation 2,3 | ||||||||||
Missing | 1 | (0.0) | 1 | (0.0) | ||||||
1 (least deprived) | 2201 | (8.0) | 117 | (4.0) | 392 | (10.9) | 323 | (3.5) | 1369 | (11.7) |
2 | 2610 | (9.5) | 340 | (11.7) | 283 | (7.9) | 1135 | (12.1) | 852 | (7.3) |
3 | 4478 | (16.2) | 309 | (10.6) | 709 | (19.8) | 1097 | (11.7) | 2363 | (20.1) |
4 | 7180 | (26.0) | 670 | (23.1) | 976 | (27.3) | 2207 | (23.6) | 3327 | (28.3) |
5 (most deprived) | 11,106 | (40.3) | 1468 | (50.5) | 1221 | (34.1) | 4580 | (49.0) | 3837 | (32.7) |
District Health Board 2,3 | ||||||||||
Northland | 6359 | (23.1) | 1539 | (53.0) | - | - | 4820 | (51.6) | - | - |
Waikato | 15,329 | (55.6) | - | - | 3581 | (100.0) | - | - | 11,748 | (100.0) |
Hawke’s Bay | 5888 | (21.4) | 1366 | (47.0) | - | - | 4522 | (48.4) | - | - |
Model of maternity care at registration 2,3 | ||||||||||
DHB | 322 | (1.2) | 120 | (4.1) | 0 | (0.0) | 201 | (2.2) | 1 | (0.0) |
General Practice | 13 | (0.0) | 1 | (0.0) | 0 | (0.0) | 4 | (0.0) | 8 | (0.1) |
Midwife | 26,367 | (95.6) | 2710 | (93.3) | 3486 | (97.3) | 8782 | (94.0) | 11,389 | (96.9) |
No LMC | 817 | (3.0) | 71 | (2.4) | 88 | (2.5) | 341 | (3.7) | 317 | (2.7) |
Obstetrician | 57 | (0.2) | 3 | (0.1) | 7 | (0.2) | 14 | (0.1) | 33 | (0.3) |
Number of antenatal care visits 2,3 | ||||||||||
Missing | 1385 | (5.0) | 218 | (7.5) | 110 | (3.1) | 618 | (6.6) | 439 | (3.7) |
0–5 | 4813 | (17.5) | 351 | (12.1) | 441 | (12.3) | 1208 | (12.9) | 2813 | (23.9) |
6–10 | 11,422 | (41.4) | 1191 | (41.0) | 1734 | (48.4) | 3557 | (38.1) | 4940 | (42.0) |
11–15 | 8896 | (32.3) | 1002 | (34.5) | 1188 | (33.2) | 3460 | (37.0) | 3246 | (27.6) |
16–20 | 941 | (3.4) | 126 | (4.3) | 99 | (2.8) | 434 | (4.6) | 282 | (2.4) |
21+ | 119 | (0.4) | 17 | (0.6) | 9 | (0.3) | 65 | (0.7) | 28 | (0.2) |
Parity of eligible pregnancy 1,3 | ||||||||||
Missing | 863 | (3.1) | 95 | (3.3) | 88 | (2.5) | 361 | (3.9) | 319 | (2.7) |
0 | 11,556 | (41.9) | 964 | (33.2) | 1277 | (35.7) | 3952 | (42.3) | 5363 | (45.7) |
1 | 7597 | (27.5) | 914 | (31.5) | 1158 | (32.3) | 2351 | (25.2) | 3174 | (27.0) |
2 | 4122 | (14.9) | 478 | (16.5) | 565 | (15.8) | 1420 | (15.2) | 1659 | (14.1) |
3 | 1844 | (6.7) | 219 | (7.5) | 274 | (7.7) | 663 | (7.1) | 688 | (5.9) |
4+ | 1594 | (5.8) | 235 | (8.1) | 219 | (6.1) | 595 | (6.4) | 545 | (4.6) |
Gestational age at delivery (weeks) 2,3 | ||||||||||
28–38 | 7974 | (28.9) | 842 | (29.0) | 921 | (25.7) | 2736 | (29.3) | 3475 | (29.6) |
39–41 | 18,702 | (67.8) | 1998 | (68.8) | 2503 | (69.9) | 6410 | (68.6) | 7791 | (66.3) |
42–43 | 900 | (3.3) | 65 | (2.2) | 157 | (4.4) | 196 | (2.1) | 482 | (4.1) |
Total | Pre-Intervention | Post-Intervention | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
Unvaccinated | Vaccinated | Unvaccinated | Vaccinated | |||||||
n | (%) | n | (%) | n | (%) | n | (%) | n | (%) | |
Control areas 1 | 12,247 | (100) | 2138 | (73.6) | 767 | (26.4) | 5797 | (62.1) | 3545 | (38.0) |
Intervention area 2 | 15,329 | (100) | 2832 | (79.1) | 749 | (20.9) | 7636 | (65.0) | 4112 | (35.0) |
Pre-Intervention | Post-Intervention | Adjusted Model 1,2 | ||||
---|---|---|---|---|---|---|
n | Proportion Vaccinated (95% CI) | n | Proportion Vaccinated (95% CI) | OR | (95% CI) | |
Region 2 | ||||||
Control areas | 2904 | 26.4 (24.5, 28.3) | 9342 | 38.0 (36.7, 39.3) | 1.67 | (1.52, 1.84) |
Intervention area | 3581 | 20.9 (19.4, 22.4) | 11,748 | 35.0 (33.9, 36.1) | 2.07 | (1.89, 2.27) |
Non-Māori 3 | ||||||
Control areas | 1370 | 36.4 (33.2, 39.6) | 4913 | 50.4 (48.4, 52.4) | 1.79 | (1.58, 2.03) |
Intervention area | 2292 | 27.4 (25.3, 29.5) | 7698 | 42.7 (41.2, 44.2) | 1.98 | (1.79, 2.20) |
Māori 3 | ||||||
Control areas | 1534 | 17.5 (15.4, 19.6) | 4429 | 24.2 (22.8, 25.6) | 1.50 | (1.29, 1.74) |
Intervention area | 1289 | 9.4 (7.7, 11.1) | 4050 | 20.4 (19.0, 21.8) | 2.42 | (1.99, 2.97) |
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Howe, A.S.; Gauld, N.J.; Cavadino, A.Y.; Petousis-Harris, H.; Dumble, F.; Sinclair, O.; Grant, C.C. Increasing Uptake of Maternal Pertussis Vaccinations through Funded Administration in Community Pharmacies. Vaccines 2022, 10, 150. https://doi.org/10.3390/vaccines10020150
Howe AS, Gauld NJ, Cavadino AY, Petousis-Harris H, Dumble F, Sinclair O, Grant CC. Increasing Uptake of Maternal Pertussis Vaccinations through Funded Administration in Community Pharmacies. Vaccines. 2022; 10(2):150. https://doi.org/10.3390/vaccines10020150
Chicago/Turabian StyleHowe, Anna S., Natalie J. Gauld, Alana Y. Cavadino, Helen Petousis-Harris, Felicity Dumble, Owen Sinclair, and Cameron C. Grant. 2022. "Increasing Uptake of Maternal Pertussis Vaccinations through Funded Administration in Community Pharmacies" Vaccines 10, no. 2: 150. https://doi.org/10.3390/vaccines10020150