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\begin{document}

\title{An evaluation of an influenza vaccination campaign targeting pregnant
women in 27 clinics in two provinces of South Africa, 2015 -- 2018.}



\author[1]{Katherine Bishop}%
\author[2]{Meredith McMorrow}%
\author[1]{Susan Meiring}%
\author[1]{Sibongile Walaza}%
\author[1]{Liza Rossi}%
\author[1]{Sarona Mhlanga}%
\author[2]{Stefano Tempia}%
\author[1]{Azwifarwi Mathunjwa}%
\author[1]{Jackie Kleynhans}%
\author[2]{Grace Appiah}%
\author[1]{Jo McAnerney}%
\author[3]{Heather J. Zar}%
\author[1]{Cheryl Cohen}%
\affil[1]{National Institute for Communicable Diseases}%
\affil[2]{Centers for Disease Control and Prevention}%
\affil[3]{University of Cape Town}%


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  \date{June 16, 2024}


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\begin{abstract}
Introduction Despite prioritization, routine antenatal influenza vaccine
coverage is \textless{}16\% in South Africa. We aimed to describe
maternal influenza vaccine coverage in 27 antenatal clinics (ANCs) in
Gauteng and Western Cape (WC) Provinces, where in collaboration with the
Department of Health (DoH), we augmented the annual influenza
vaccination programme among pregnant women. Methods From 2015 through
2018, 40 230 additional doses of influenza vaccine were added to the
available stock and administered as part of routine antenatal care.
Educational talks were given daily and data were collected on women
attending ANCs. We compared characteristics of vaccinated and
unvaccinated women using multivariable logistic regression. Results We
screened 62 979 pregnant women during the period when Southern
Hemisphere influenza vaccines were available (27 068 in Gauteng and 35
911 in WC). Vaccine coverage at the targeted clinics was 78.7\% (49
355/62 682), although pregnant women in WC were more likely to be
vaccinated compared to those in the Gauteng (Odds ratio (OR) =3.7
p\textless{}0.001). Women aged 25---29 and \textgreater{}35 years were
less likely to be vaccinated than women aged 18---24 years (OR=0.9
p=0.053; OR=0.9 p\textless{}0.001). HIV positive status was not
associated with vaccination (OR=1.0 p=0.266). Reasons for not
vaccinating included: vaccine stock-outs where ANCs depleted available
stock of vaccines and/or were awaiting delivery of vaccines (54.6\%,
6949/12 723), refusal/indecision (25.8\%, 3 285), and current illness
that contraindicated vaccination (19.6\%, 2 489). Conclusion Antenatal
vaccination uptake was likely improved by the increased vaccine supply
and vaccine education offered during our campaign.%
\end{abstract}%



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