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Abstract
COVID-19 vaccination during pregnancy is safe and effective in reducing the risk of complications. However, the uptake is still below targets worldwide. This study aimed to explore the factors associated with COVID-19 vaccination uptake among pregnant women since data on this topic is scarce in low-to-middle-income countries. A retrospective cohort study included linked data on COVID-19 vaccination and pregnant women who delivered a singleton live birth from August 1, 2021, to July 31, 2022, in Rio de Janeiro City, Brazil. Multiple logistic regression was performed to identify factors associated with vaccination during pregnancy, applying a hierarchical model and describing odds ratio with 95% confidence intervals. Of 65,304 pregnant women included in the study, 53.0% (95% CI, 52–53%) received at least one dose of COVID-19 vaccine during pregnancy. Higher uptake was observed among women aged older than 34 (aOR 1.21, 95%CI 1.15–1.28), black (aOR 1.10, 1.04–1.16), or parda/brown skin colour (aOR 1.05, 1.01–1.09), with less than eight years of education (aOR 1.09, 1.02–1.17), living without a partner (aOR 2.24, 2.16–2.34), more than six antenatal care appointments (aOR 1.92, 1.75–2.09), and having a previous child loss (OR 1.06, 1.02–1.11). These results highlight the need for targeted educational campaigns, trustful communication, and accessibility strategies for specific populations to improve vaccination uptake during pregnancy.
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1 Instituto de Patologia Tropical e Saúde Pública da Universidade Federal de Goiás, Goiânia, Brazil (GRID:grid.411195.9) (ISNI:0000 0001 2192 5801); Programa de Pós-Graduação em Ciências da Saúde da Faculdade de Medicina da Universidade Federal de Goiás, Goiânia, Brazil (GRID:grid.411195.9) (ISNI:0000 0001 2192 5801)
2 Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Centro de Integração de Dados e Conhecimento para Saúde (CIDACS), Salvador, Brazil (GRID:grid.418068.3) (ISNI:0000 0001 0723 0931)
3 Secretaria Municipal de Saúde, Rio de Janeiro, Brazil (GRID:grid.419738.0) (ISNI:0000 0004 0525 5782); Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil (GRID:grid.8536.8) (ISNI:0000 0001 2294 473X)
4 Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Centro de Integração de Dados e Conhecimento para Saúde (CIDACS), Salvador, Brazil (GRID:grid.418068.3) (ISNI:0000 0001 0723 0931); Universidade Federal da Bahia, Faculdade de Medicina, Salvador, Brazil (GRID:grid.8399.b) (ISNI:0000 0004 0372 8259)
5 Secretaria Municipal de Saúde, Rio de Janeiro, Brazil (GRID:grid.419738.0) (ISNI:0000 0004 0525 5782)
6 Universidade do Estado do Rio de Janeiro, Departamento de Epidemiologia, Instituto de Medicina Social, Rio de Janeiro, Brazil (GRID:grid.412211.5) (ISNI:0000 0004 4687 5267); Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil (GRID:grid.8536.8) (ISNI:0000 0001 2294 473X)
7 Department of Infectious Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK (GRID:grid.8991.9) (ISNI:0000 0004 0425 469X)
8 Programa de Pós-Graduação em Ciências da Saúde da Faculdade de Medicina da Universidade Federal de Goiás, Goiânia, Brazil (GRID:grid.411195.9) (ISNI:0000 0001 2192 5801)
9 Ministério da Saúde, Secretaria de Vigilância em Saúde e Ambiente, Brasília, Brazil (GRID:grid.414596.b) (ISNI:0000 0004 0602 9808)
10 Universidade de Brasília, Escola de Governo Fiocruz Brasília, Núcleo de Medicina Tropical, Brasília, Brazil (GRID:grid.7632.0) (ISNI:0000 0001 2238 5157)
11 Universidade Federal da Bahia, Faculdade de Medicina, Salvador, Brazil (GRID:grid.8399.b) (ISNI:0000 0004 0372 8259); Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Centro de Integração de Dados e Conhecimento para Saúde (CIDACS), Salvador, Brazil (GRID:grid.418068.3) (ISNI:0000 0001 0723 0931)