Eurosurveillance - Volume 31, Issue 7, 19 February 2026

Pregnant women and their newborns are at increased risk of severe outcomes from influenza and COVID-19 infections; maternal vaccination is recommended. However, no routine surveillance of maternal vaccine coverage exists in Norway.

To provide insights into vaccination coverage and timing during pregnancy.

This population-based registry study included women who gave birth in Norway during 1 October 2023–30 September 2024. Data on influenza and COVID-19 vaccinations administered during 1 October 2023–10 May 2024 were obtained from the national immunisation registry and linked to birth data from the Medical Birth Registry Norway. Cumulative coverage included vaccines administered during pregnancy, with sub-analyses focusing on second and third trimester vaccinations, month of delivery and maternal age.

Overall influenza vaccination coverage was 29.9% (15,915/53,161), with 22.3% (11,856/53,161) vaccinated in the second or third trimester. Coverage increased from 16.4% (7,287/44,454) in October to 26.4% (12,982/49,170) in November and plateaued thereafter. Coverage peaked among women delivering in February (50.8%; 2,159/4,248) and declined afterwards. COVID-19 vaccination coverage was 12.1% (6,423/53,161) with 10.1% (5,349/53,161) in the second or third trimester, following a similar pattern to influenza. Overall, 11.4% received both vaccines. The lowest uptake (< 19%) was among women aged 25 years or younger.

Coverage of maternal influenza and COVID-19 vaccinations for 2023/24 remained low, with missed opportunities to reach pregnant women beyond November 2023. Overall, the coverage was lowest among women aged 25 years or younger. Strengthened efforts are needed to increase vaccination coverage among pregnant women and reduce gaps in protection.

Few studies have quantified mortality caused by healthcare-associated infections (HAIs) of all types.

This work’s objective was to estimate the overall impact of HAIs on mortality in Spain.

Spain performs annually a point prevalence survey of HAIs and antimicrobial use in hospitalised patients. In 2022 and 2023, prospective follow-ups of patients to evaluate their status 30 days after the survey (still admitted, discharged, deceased) were additionally conducted. This information allowed assessing the effect of HAIs on mortality, by logistic regression. We calculated the attributable fraction among the exposed (patients with HAIs) and the population attributable fraction (among all hospitalised patients). Finally, we estimated the annual number of deaths attributable to HAIs.

Of 107,781 inpatients included in the study, 56,323 (52.26%) were males and 51,458 (47.7%) females. Most patients (n = 59,790; 55.47%) were ≥ 65 years old. The HAI prevalence was 7.8% (n = 8,375). Crude mortality rate was 5.7% (5,715/99,406) among patients without HAIs and 11.0% (918/8,375) among those with HAIs. The adjusted odds ratio (AOR) for inpatient mortality associated with HAIs was 1.70 (95%CI: 1.56–1.86). The attributable fraction of deaths due to HAIs among inpatients who died with a HAI was 41.2% and 3.2% among all inpatient deaths. The estimated annual number of inpatient deaths attributable to HAIs in Spain was 6,774.

In Spain, HAIs highly impact mortality. The number of deaths attributable to HAIs is over three times that caused by road traffic accidents. Addressing this requires immediate strengthening of infection prevention programmes across healthcare settings and their thorough implementation.