Supporting Information_Raw Data_250624

<b>Introduction</b>Pregnant women are considered a high-risk group for COVID-19, and a priority for vaccination. Routine antenatal care (ANC) provides an opportunity to track trends and factors associated with vaccine uptake. We sought to evaluate COVID-19 vaccine uptake among pregnant women attending ANC and assess the factors associated with vaccine uptake in Zambia.<b>Methods</b>We conducted a repeated cross-sectional study in 39 public health facilities in four districts in Zambia from September 2021 to September 2022. Pregnant women aged 15-49 years were enrolled during their first ANC visit. Every month, ~20 women per facility were interviewed during individual HIV counseling and testing. We estimated vaccine uptake as the proportion of eligible participants who reported receiving the COVID-19 vaccine.<b>Results </b>A total of 9,203 pregnant women were screened, of which 9,111 (99%) were eligible and had vaccination status. Of the 9,111 included in the analysis, 1,818 (20%) had received the COVID-19 vaccine during the study period, with a trend of increasing coverage with time (0.5% in September 2020, 27% in September 2022). Conversely, 3,789 (42%) reported not being offered a COVID-19 vaccine. We found that women aged 40-49 years, had no education or attained some primary school education, were not employed, and had prior COVID-19 infection were significantly associated with vaccine uptake.<b>Conclusion</b>COVID-19 vaccine uptake among pregnant women was lower than estimates from the general population (27% across the four districts in September 2022), pointing to missed opportunities to protect this high-risk group. ANC visits were a viable point for conducting COVID-19 surveillance. Incorporating the vaccine as part of the routine ANC package might increase coverage in this group.

<b>引言</b>孕产妇被视为新型冠状病毒肺炎（COVID-19）的高危人群，同时也是疫苗接种的优先对象。常规产前保健（Antenatal Care，简称ANC）为追踪疫苗接种率的变化趋势及其相关影响因素提供了契机。本研究旨在评估赞比亚参与产前保健的孕产妇的新冠疫苗接种率，并分析其疫苗接种的相关影响因素。<b>研究方法</b>本研究于2021年9月至2022年9月期间，在赞比亚4个区县的39家公立医疗卫生机构开展重复横断面研究。研究纳入首次前来产前保健就诊的15~49岁孕产妇作为研究对象。每月在各机构内，约有20名孕产妇在接受一对一艾滋病咨询与检测时接受访谈。本研究以报告已接种新冠疫苗的合格研究对象占比，作为疫苗接种率的评估指标。<b>研究结果</b>本研究共筛查9203名孕产妇，其中9111名（99%）符合研究纳入标准且具备疫苗接种状态相关数据。在纳入分析的9111名研究对象中，1818名（20%）在研究期间完成了新冠疫苗接种，疫苗接种覆盖率随时间呈上升趋势（2020年9月为0.5%，2022年9月为27%）。与之相对，3789名（42%）研究对象报告未被提供新冠疫苗接种服务。本研究发现，40~49岁、未接受过教育或仅完成小学阶段教育、无业以及既往感染过新冠病毒的孕产妇，其疫苗接种率显著更高。<b>结论</b>孕产妇的新冠疫苗接种率低于普通人群的预估接种率（2022年9月四个区县的整体接种率为27%），反映出该高危人群的疫苗接种存在诸多错失的保护契机。产前保健就诊是开展新冠病毒感染监测的可行场景。将新冠疫苗接种纳入常规产前保健服务包，或可提升该人群的疫苗接种覆盖率。