(226) COVID-19 pandemic impact on perinatal vaccination trends

During the COVID-19 pandemic, vaccinations during pregnancy became a contentious topic. We hypothesized that the pandemic has been associated with decreased uptake of maternal and neonatal vaccination rates using interrupted time series analysis.


Study Design:

We performed a retrospective cohort study of 103,549 births from 2016 to 2024 from a large regional health system with 12 delivery hospitals in the American South. An interrupted time series with segmented regression was used to assess trends in maternal Tdap, neonatal hepatitis B, and coordinated vaccination rates. The COVID-19 interruption point was defined as March 1, 2020. Age-stratified analysis was performed to identify vulnerable populations.


Results:

Pre-COVID vaccination rates increased monthly for maternal Tdap (+0.34 percentage points per month), neonatal hepatitis B (+0.13 percentage points per month), and coordinated vaccination (+0.51 percentage points per month, all p< 0.001). COVID-19 produced non-significant immediate declines but significant sustained trend reversals for maternal Tdap (-0.81 percentage points per month), neonatal hepatitis B (-0.30 percentage points per month), and coordinated vaccination (-1.04 percentage points per month, all p< 0.001, Figure 1). Age stratification revealed heterogeneous immediate COVID impacts with mothers aged 40 years and older experiencing the largest decline (-7.6 percentage points), while mothers aged 25-29 years showed immediate improvement (+1.7 percentage points). All age groups demonstrated post-COVID declining trends.


Conclusion:

At a large regional health system in the South, COVID-19 reversed favorable pre-pandemic maternal and neonatal vaccination trends, with age-dependent immediate impacts but universally negative sustained effects. Targeted interventions addressing age-specific vulnerabilities are essential for restoring perinatal vaccination coordination.