Mapping the maternal vaccination journey and influencing factors for Māori women in Aotearoa New Zealand: a qualitative study

The role of narratives in promoting vaccine confidence among Indigenous peoples in Canada, the United States, Australia, and New Zealand: a scoping review

BACKGROUND

Many Indigenous youth and young adults in Canada, the United States, Australia, and New Zealand have reported low vaccine confidence, which has been linked to lower vaccination rates for COVID-19, MMR, HPV, DTaP-IPV-Hib, and pneumococcal conjugate vaccines. Narrative-based health promotion approaches, including those focused on strengthening vaccine confidence, have been used in public health interventions. Scoping reviews have become increasingly valued for their rigorous and reproducible exploration of evidence in public health research. The aim of this scoping review was to understand the extent and types of evidence related to the facilitators, challenges, and benefits of narrative-based health promotion approaches in vaccine confidence interventions within Indigenous populations.

METHODS

This review adhered to the Joanna Briggs Institute (JBI) guidelines for scoping reviews using Covidence online software to streamline the review process. Database searches were conducted in MEDLINE, Embase, Web of Science, PsycINFO, and PubMed, as well as Google search to identify both academic and gray literature articles on the role of narratives in promoting vaccine confidence published between January 2000 and April 2024. Charted data were ranked in a numerical summary and analyzed using qualitative content analysis. The review process embraced a two-eyed seeing approach.

RESULTS

The searches identified 306 records. After the screening process, 45 sources (35 peer-reviewed articles, eight gray literature, and two preprint articles) were included in the final review. The key facilitators of narrative-based approaches to promote vaccine confidence were community engagement, tailored and culturally safe interventions, and trusted messengers and sources of information. The challenges discussed in the literature were linked to mistrust of government and healthcare services and to misinformation narratives. The most frequently reported benefits were the development of community-based resources, culturally safe and relevant interventions, building trust and respectful relationships, and improved vaccination rates.

CONCLUSION

This review confirmed the important contribution of narrative-based health promotion approaches in strengthening vaccine confidence among Indigenous populations. This finding underscores the importance of respecting Indigenous sovereignty and engaging community perspectives to repair trust and improve vaccination rates.

Interventions to improve vaccine coverage of pregnant women in Aotearoa New Zealand

Introduction Maternal vaccination against influenza and pertussis protects mothers and babies from severe disease and is recommended and funded in Aotearoa New Zealand. Despite this, maternal vaccination uptake is low, varies by region and is inequitable, with Māori and Pacific māmā (mothers) less likely to receive vaccination. Aim To determine what interventions currently exist to support and encourage maternal vaccination against influenza and pertussis and what changes and interventions could be implemented to improve coverage, with a focus on Māori and Pacific hapū māmā (pregnant mothers). Methods Interviews with six participants with diverse roles in the vaccination workforce were conducted. Participants were involved in education, certification and supporting vaccinators, high-level strategising, and vaccination. Interviews aimed to determine what interventions currently exist for hapū māmā, what changes need to be made to improve coverage and how Māori and Pacific people have been specifically engaged. Qualitative data analysis was used to determine themes. Results Participants identified that interventions must focus on prioritising and emphasising the importance of maternal vaccination, promoting collaboration and innovation, making interventions accessible, and empowering Māori- and Pacific-driven avenues to vaccination. To create positive foundations, participants identified the importance of building and maintaining trust and affording mothers' time and autonomy in vaccination. Discussion Healthcare professionals need to proactively engage hapū māmā about vaccination and collaborate in service delivery. Interventions must be suitably accessible and allow for the autonomy of hapū māmā over vaccination decisions. Equity should be considered at the foundation of vaccine interventions to improve the accessibility of vaccines to all communities.