Determinants of influenza and pertussis vaccination uptake in pregnancy: a multi-centre questionnaire study of pregnant women and healthcare professionals

Christopher Wilcox; Anna Calvert; Jane Metz; Eliz Kilich; Rachael Macleod; Kirsten Beadon; Paul Heath; Asma Khalil; Adam Finn; Matthew Snape; Tushna Vandrevala; Tom Nadarzynski; Matthew Coleman; Christine Jones

doi:10.3399/bjgp19X703301

Abstract

Background Uptake rates of influenza and pertussis vaccination in pregnancy remain suboptimal.

Aim To determine the acceptability of routine vaccination among pregnant women; the confidence of maternity healthcare professionals (HCPs) discussing vaccination; and HCP opinion with regards to the optimum healthcare site for vaccine administration.

Method Separate questionnaires for pregnant women and maternity HCPs were distributed within four NHS trusts in South England from July 2017–January 2018.

Results Responses from 314 pregnant women and 204 HCPs (18% obstetricians, 75% midwives [both hospital and community], 7% unidentified) were analysed. Actual/intended uptake of influenza and pertussis vaccination was 78% and 92%, respectively. The commonest reason for declining vaccination was feared side effects for their child. White British women (79%) were significantly more accepting of influenza (odds ratio [OR] 3.25, 95% confidence interval [CI] = 1.67 to 6.32) and pertussis vaccination (OR 4.83, 95% CI = 1.77 to 13.19) compared with non-white British women. Among HCPs, 25% were not-at-all or slightly confident discussing vaccination. Obstetricians felt significantly more confident discussing pertussis vaccination than midwives (OR 2.05, 95% CI = 1.02 to 4.12). Among HCPs, 53%, 25%, and 16% thought vaccines should be administered in primary care (general practice), community midwifery, and the hospital setting, respectively.

Conclusion Misconceptions exist regarding safety and efficacy of maternal vaccination, and framing information towards safety for the child may increase uptake. Education of HCPs is essential, and vaccine promotion should be incorporated into routine antenatal care, with an emphasis on women from ethnic minorities. Administration of vaccines in primary care may present a logistical barrier to women, however support for alternative sites appears low among HCPs.

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Determinants of influenza and pertussis vaccination uptake in pregnancy: a multi-centre questionnaire study of pregnant women and healthcare professionals

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