# Evaluation of Maternal Immunization Rates in Primary Care: A Retrospective Study From Selected Family Health Centers in İstanbul, Türkiye

## TL;DR

This study examines how often pregnant women in Istanbul receive recommended vaccines and finds that completing antenatal care visits is linked to higher vaccination rates.

## Contribution

The study provides new insights into maternal vaccination coverage and its association with antenatal care in Türkiye.

## Key findings

- 89.7% of pregnant women received at least one vaccine, but coverage for hepatitis B and COVID-19 was low.
- Completing antenatal care visits was strongly associated with higher vaccination rates during pregnancy.
- Having a complete Td/Tdap vaccination was independently linked to higher odds of vaccination during pregnancy.

## Abstract

To assess maternal vaccination coverage in primary care and to examine its association with completion of antenatal care visits and maternal characteristics in Türkiye.

A retrospective record-based observational study including 996 pregnancies registered at Family Health Centers in Istanbul (2020–2022) was analyzed. Vaccination records for tetanus–diphtheria (Td), tetanus–diphtheria–acellular pertussis (Tdap), hepatitis B, influenza, and coronavirus disease 2019 (COVID-19) were retrieved from electronic health records and the National Vaccination Tracking System. Women attending all four scheduled antenatal care visits were classified as having complete antenatal care. Descriptive analyses, chi-square tests, and binary logistic regression analysis were performed.

Overall, 89.7% of pregnant women received at least one vaccine. Complete vaccination rates were 79.7% for Td/Tdap, while complete hepatitis B immunization status was observed in 9.8%, and complete COVID-19 vaccination in 10.7%. Two-thirds (66.4%) completed antenatal care visits. Complete antenatal care was independently associated with higher odds of vaccination during pregnancy (aOR = 2.91, 95% CI: 1.91–4.44), having a lifetime immunization record (aOR = 3.12, 95% CI: 1.74–5.61) and complete Td/Tdap vaccination (aOR = 2.16, 95% CI: 1.57–2.98).

Maternal vaccination coverage in Türkiye remains below international targets except for Td/Tdap. Greater continuity of structured antenatal care and continuity of care visits may be associated with higher maternal vaccination uptake. In addition integrating all recommended maternal vaccines into national protocols may support improvements in immunization coverage.