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Recording available 2/16-5/2

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Poster Session 3

Category: Health Equity/Community Health

Poster Session 3

(824) Association of Socioeconomic Deprivation with Maternal Vaccination Rates Before and After COVID pandemic

Thursday, February 12, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Judy Jiang, MD (she/her/hers)

MetroHealth Medical Center/Case Western Reserve University
Cleveland, Ohio, United States

Coauthor(s)

Bhavana Janga, MD

MetroHealth Medical Center / Case Western Reserve University
Cleveland, Ohio, United States
HH

Hannah Hill, MS

MetroHealth Medical Center
The MetroHealth System, Ohio, United States
Kelly S. Gibson, MD (she/her/hers)

MFM Division Director
MetroHealth Medical Center/ Case Western Reserve University
Cleveland, Ohio, United States
Hansika R. Kunduru

Case Western Reserve University
Case Western Reserve University, Ohio, United States

Objective:
To examine the trends in uptake of recommended vaccines for pregnant persons from 2016 to 2024 and to determine how these trends differ when looking at patients stratified by Social Vulnerability Index (SVI) and Area Deprivation Index (ADI) as measures of socioeconomic deprivation.

Study Design:
Retrospective cohort study utilizing the Epic Cosmos aggregated data set, which was used to query diagnoses, vaccinations, and temporal data from Jan 2016 to Dec 2024 for patients pregnant at the time of the vaccination. Filter presets allowed us to see the number of patients who accepted the tetanus, diphtheria and pertussis (TDaP), influenza, and COVID-19 vaccines during pregnancy. Trends were examined by fitting multivariable logistic regression models predicting vaccination on year and relevant independent variables.

Results:
Data on 23,118,213 pregnant patients were queried. TDaP vaccination rates trend up from 43.1% in 2016 to a peak in 2020 at 52.2% and then trended back down to 43.4% in 2024. Influenza vaccination shifted from 19.8% in 2016 to a peak of 29% in 2020 followed by a drop back to 19% in 2024. COVID-19 vaccinations peaked in 2021 at 14.4% of the pregnant population but then dropped to 0.04% in 2024. These trends were similar for all races and ethnicities. When examining patients stratified by quartiles of ADI and SVI, vaccination rates were found to inversely correlate with both measures of socioeconomic deprivation. Patients in the first SVI quartile (0-25), indicating the least social vulnerability, have the highest rates of vaccination and those in the last quartile have the lowest vaccination rates (p < 0.001). Results were unchanged when stratified by ADI.

Conclusion:
After the COVID pandemic, vaccination rates are decreasing in pregnant patients. Patients with the highest levels of social vulnerability had the lowest rates of vaccination. These results highlight the importance of vaccine education and outreach to those most vulnerable to infection.