Usual Source of Care and Flu Vaccination Rates in Pregnant Women

Access to care has been an increasingly important throughout the COVID-19 pandemic. While always a critical part of public health, a pandemic often lays bare the inadequacies within our healthcare and public health systems.

Having access to not only medical providers, but resources like medications and treatments, and healthcare facilities, is a vital part of health, but also the awareness for what health means. When people don’t have a usual source of care or readily access to medical resources, what does this trickle down to? Does it impact their definition of health or willingness to pursue preventative medicine?

A new study sought to address the association between a usual source of care and influenza vaccination rates among pregnant women. As pregnant individuals and infants are at higher risk for influenza-related complications, meaning that vaccination becomes that much more important. Often though, vaccination rates for the flu vaccine can be lower in pregnant women, so researchers wanted to address the potential association between usual source of care and seasonal flu vaccination rates for those women pregnant between 2012-2016.

By utilizing a retrospective study via pooled data from the Medical Expenditure Panel survey, the team used a multivariable log-binomial regression model to fully understand a potential association. A total of 1756 pregnant women were included in the study and roughly half received a seasonal flu shot within the past year. The authors noted that “About a third (unweighted n=593, 33.8%; weighted n = 936,349, 30.0%) of the study population did not have a usual source of care. Pregnant women with a usual source of care had an unweighted seasonal influenza vaccination rate of 56.1% compared to 41.8% of those without a usual source of care (weighted 58.5%, 95% CI=54.3%-62.6% versus 45.1%, 95% CI=39.2%-51.0%, respectively). The seasonal influenza vaccination rate among Black non-Hispanic individuals was 43.3%, whereas women of all other races had seasonal influenza vaccination rates above 50%.”

Interestingly, they noted that “The top five main reasons provided by pregnant women for not having a usual source of care were seldom or never being sick (55.7%), not having health insurance (10.6%), having recently moved to a new area (9.9%), cost (4.9%), and not knowing where to go (3.3%). Finally, in order to confirm our finding that only 70% of pregnant women had a usual source of care, we also estimated the prevalence of having a usual course of care provider in the general population between the ages of 18 to 44 years old in MEPS and found that it was significantly lower at 63%. This finding is in line with our expectation that pregnant women were more likely to have a usual source of care provider than the general population of the same age.”

Ultimately, what this study sheds light on a need for education around preventative medicine regardless of feeling sick and that there are free options for vaccination and usual sources of care without a need for health insurance. Outreach for those pregnant women without a usual source of care is vital for not only influenza vaccine initiatives, but also broadening preventative care for the mother and child.