You will be presented with a collection of medical randomized controlled trial (RCT) reports addressing a shared clinical question -- for instance, the efficacy of a medical intervention on a disease or condition. Given the titles and abstracts of these reports, your task is to generate the conclusion of the systematic review article synthesizing the key findings. Your conclusion should be a few sentences long. In your response, include only the conclusion and no other text. The RCT reports are below.



Title 1:
Neighborhood determinants of 2009 pandemic A/H1N1 influenza vaccination in Montreal, Quebec, Canada.
Abstract 1:
Neighborhood-level analyses of influenza vaccination can identify the characteristics of vulnerable neighborhoods , which can inform public health strategy for future p and emics . In this study , the authors analyzed rates of  2009 p and emic A/H1N1 influenza vaccination  in Montreal , Quebec , Canada , using individual-level vaccination records from a vaccination registry with census , survey , and administrative data to estimate the population at risk . The neighborhood socioeconomic and demographic determinants of vaccination were identified using Bayesian ecologic logistic regression , with r and om effects to account for spatial autocorrelation . A total of 918,773 ( 49.9 % ) Montreal residents were vaccinated against p and emic A/H1N1 influenza  from October 22 , 2009 , through April 8 , 2010 . Coverage was greatest among females , children under age 5 years , and health-care workers . Neighborhood vaccine coverage ranged from 33.6 % to 71.0 % . Neighborhoods with high percentages of immigrants ( per 5 % increase , odds ratio = 0.90 , 95 % credible interval : 0.86 , 0.95 ) and material deprivation ( per 1-unit increase in deprivation score , odds ratio = 0.93 , 95 % credible interval : 0.88 , 0.98 ) had lower vaccine coverage . Half of the Montreal population was vaccinated ; however , considerable heterogeneity in coverage was observed between neighborhoods and subgroups . In future vaccination campaigns , neighborhoods that are material ly deprived or have high percentages of immigrants may benefit from focused interventions


Title 2:
Influenza vaccination during pregnancy: coverage rates and influencing factors in two urban districts in Sydney.
Abstract 2:
BACKGROUND Pregnant women have an increased risk of complications from influenza . Influenza vaccination during pregnancy is considered effective and safe ; however estimates of vaccine coverage are low . This study aim ed to determine  influenza vaccination coverage and factors associated with vaccine uptake in pregnant women in two Sydney-based health districts . METHODS A r and om sample of women who delivered a baby in a public hospital in Sydney and South-Western Sydney Local Health Districts between June and September 2012 were surveyed using a computer assisted telephone interviewing service . RESULTS Of the 462 participants ( participation rate 92 % ) , 116 ( 25 % ) reported receiving the influenza vaccine during their pregnancy . In univariate analysis , vaccination coverage varied significantly depending on antenatal care type , hospital of birth , and parity ( p<0.05 ) , but not for age category , highest level of education , country of birth , language spoken at home , or Aboriginal status . Women who received antenatal care through a general practitioner ( GP ) had 2.3 ( 95 % CI 1.4 - 3.6 ) times the odds ( unadjusted ) of receiving the influenza vaccination  than those who received their antenatal care through a public hospital . The main reason cited for vaccination was GP recommendation ( 37 % ) , while non- recommendation ( 33 % ) and lack of knowledge ( 26 % ) were cited as main reasons for not receiving the vaccination . 30 % of women recalled receiving a provider recommendation for the vaccination and these women had 33.0 times the odds ( unadjusted ) of receiving the vaccination than women who had not received a recommendation . In a multivariate model a provider recommendation was the only variable that was significantly associated with vaccination ( OR 41.9 ; 95 % CI 20.7 - 84.9 ) . CONCLUSION Rates of influenza vaccination during pregnancy are low . There is a significant relationship between healthcare provider recommendation for the vaccination and vaccine uptake . Increasing provider recommendation rates has the potential to increase coverage rates of influenza vaccination in pregnant women
There was consistently a relationship between SES and influenza immunization , which varied according to how SES was measured .