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Jiang F, Ye X, Wang Y, Tang N, Feng J, Gao Y, Bao M. Factors associated with pregnant women's willingness to receive maternal pertussis vaccination in Guizhou Province, China: An exploratory cross-sectional study. Hum Vaccin Immunother 2024; 20:2331870. [PMID: 38575528 PMCID: PMC10996833 DOI: 10.1080/21645515.2024.2331870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 03/14/2024] [Indexed: 04/06/2024] Open
Abstract
The rise in pertussis incidence among infants in Guizhou, China underscores the need for maternal acellular pertussis vaccine (aP) immunization, a key strategy in protecting infants from severe health consequences. However, the willingness of pregnant women in Guizhou to receive this vaccine is not well-understood. This study aimed to explore pregnant women's intentions toward maternal pertussis vaccination in Guizhou and identify the associated factors. A questionnaire based on the health belief model, was administered in an exploratory cross-sectional study from January to February 2022. Data from 564 participants were collected and analyzed. The chi-square test, Mann-Whitney U test, and Poisson regression were used to identify potential factors associated with vaccination intentions. Participants' median age was 27 y (interquartile range (IQR): 24-31), and the median number of children per participant was one. The study found that only 36.0% of the participants intended to receive the aP vaccine while 64.0% were uncertain or negative in this regard. Significant factors associated with intentions to vaccinate included perceived barriers and cues for action and perceived benefits. The major barriers for low vaccination intentions were safety concerns for both the fetus and the mother, and family members' negative attitudes. Free vaccines, perceiving preventive benefits, observing other pregnant women getting vaccinated, and healthcare provider recommendations may facilitate vaccination intentions. Multiple immune strategies should be developed or optimized to cope with the resurgence of pertussis.
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Affiliation(s)
- Feng Jiang
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
| | - Xingui Ye
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
| | - Ying Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Ning Tang
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
| | - Jun Feng
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
| | - Yuanxue Gao
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang, China
| | - Meiling Bao
- School of Public Health, Guizhou Medical University, Guiyang, China
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Raza MA, Aziz S, Iftikhar D, Anjum I, Fialova D. Addressing quality medication use among migrant patients: Establishment of an organization to provide culturally competent medication care. Saudi Pharm J 2024; 32:101922. [PMID: 38318317 PMCID: PMC10840353 DOI: 10.1016/j.jsps.2023.101922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 12/12/2023] [Indexed: 02/07/2024] Open
Abstract
As the global landscape continues to witness an increase in migration, the healthcare community faces an evolving challenge: the provision of quality medication care to migrant patients. Language barriers, cultural differences, and a lack of understanding of the local healthcare system can often impede the effective management of medications and access to healthcare services among migrant populations. Pharmacists, as medication experts, are dignified to make a substantial impact in bridging the gap between migrants and quality healthcare. Their expertise in medication management, accessibility, and counseling positions them as critical healthcare providers for this patient population. Pharmacies and pharmacists can serve as trusted hubs where migrants receive not only essential medications but also culturally sensitive support in navigating the healthcare system. This commentary article highlights the critical importance of culturally competent medication care for migrant patients and the central role that pharmacists can play in this endeavor. By establishing organization dedicated to this cause lead by pharmacists, we can not only address an urgent healthcare concern but also set a precedent for a healthcare system that values inclusivity, cultural competence, and equitable access to quality medication care for all, regardless of their cultural background.
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Affiliation(s)
- Muhammad Ahmer Raza
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, Czech Republic
| | - Shireen Aziz
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, Czech Republic
| | | | - Irfan Anjum
- Department of Basic Medical Sciences, Shifa College of Pharmaceutical Sciences, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Daniela Fialova
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University in Prague, Czech Republic
- Department of Geriatrics and Gerontology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
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Wang M, Li M, Li X, Chen X, Jiang F, A K, Wang Z, Zhang L, Lu Y, Peng W, Wang W, Fu C, Wang Y. Intention and Attitude to Accept a Pertussis Cocooning Vaccination among Chinese Children's Guardians: A Cross-Sectional Survey. Int J Environ Res Public Health 2022; 19:16282. [PMID: 36498351 PMCID: PMC9740915 DOI: 10.3390/ijerph192316282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/27/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE to assess Chinese children's guardians' intentions and attitudes toward accepting a pertussis cocooning vaccination and its determinants. METHODS a self-administered questionnaire was designed based on a theoretical framework that originated mainly from the reasoned action approach. Associations between questionnaire variables and outcomes were assessed using univariate and multivariate analyses with odds ratios (OR), regression coefficients (β), and their 95% confidence intervals (CIs). RESULTS among 762 eligible participants, most (80.71%) reported a positive intention to accept a pertussis cocooning vaccination. The guardians' positive intention was related to the children's pertussis vaccination experience (OR = 2.483, 95% CI: 1.340-4.600). Guardians who had a positive attitude towards pertussis vaccination (OR = 1.554, 95% CI: 1.053-2.296), higher subjective norms (OR = 1.960, 95% CI: 1.371-2.802) and better perceived behavioral control (OR = 7.482, 95% CI: 4.829-11.591) stated a higher intention to receive a pertussis cocooning vaccination. The mean attitude score was 3.88 ± 0.863. Greater risk perception about pertussis (β = 0.390, 95% CI: 0.298-0.483), stronger obligation from moral norms (β = 0.355, 95% CI: 0.279-0.430), and good knowledge (β = 0.108, 95% CI: 0.070-0.146) were significantly related to positive attitude toward pertussis cocooning vaccination among guardians. CONCLUSIONS Chinese children's guardians held positive intentions and attitudes toward accepting a pertussis cocooning vaccination. The current findings described the determinants of such intention and attitude and provided knowledge based on improving guardians' intentions for policymakers if cocooning vaccinations or related immunization strategies are implemented in China in the future.
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Affiliation(s)
- Meng Wang
- School of Public Health, Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Mengying Li
- School of Public Health, Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Xinghui Li
- Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Xiaoli Chen
- School of Public Health, Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Feng Jiang
- Institute of Expanded Programme on Immunization, Guizhou Provincial Center for Disease Control and Prevention, Guiyang 550004, China
| | - Kezhong A
- Institute of Immunization, Qinghai Provincial Center for Disease Control and Prevention, Xining 810007, China
| | - Zhiguo Wang
- Department of Expanded Programmed on Immunization, Jiangsu Provincial Centre of Disease Control and Prevention, Nanjing 210009, China
| | - Liping Zhang
- Minhang Center for Disease Control and Prevention, Shanghai 201101, China
| | - Yihan Lu
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai 200032, China
| | - Wenjia Peng
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai 200032, China
| | - Weibing Wang
- Department of Epidemiology, Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai 200032, China
| | - Chaowei Fu
- School of Public Health, Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
| | - Ying Wang
- School of Public Health, Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai 200032, China
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Homer CSE, Javid N, Wilton K, Bradfield Z. Vaccination in pregnancy: The role of the midwife. Front Glob Womens Health 2022; 3:929173. [PMID: 36353468 PMCID: PMC9637860 DOI: 10.3389/fgwh.2022.929173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 10/07/2022] [Indexed: 11/14/2022] Open
Abstract
Midwives are the front-line workers providing maternity care for women in many countries. The role of the midwife includes providing information about, and recommendations for, maternal vaccination in pregnancy and for the baby in the postnatal period. Vaccinations recommended in pregnancy include those to prevent influenza, pertussis, tetanus and now COVID-19. Vaccinations for the newborn baby include hepatitis B. Healthcare professionals play an important role in influencing decision-making around vaccination and midwives are key in supporting vaccination uptake. Midwives are strong influencer in women's decisions around vaccination for themselves and their babies. The COVID-19 vaccination programs have shone a light on vaccination in pregnancy especially as SARS-COV-2 infection has significant adverse effects in pregnancy. COVID-19 vaccination has been shown to be safe and effective in pregnancy. Despite this, there is vaccine hesitancy from pregnant women in many countries. Midwives play a unique role in the provision of care to women and families but they need specific support and information regarding vaccination in pregnancy. Targeted education, supportive mentoring and supervision and opportunities to lead innovative ways of ensuring vaccine access is logistically easy and possible are all needed. This Commentary outlines the key vaccinations recommended in pregnancy including COVID-19 vaccination and highlights some strategies to scale-up vaccination programs in pregnancy with a particular focus on the role of midwives.
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Affiliation(s)
- Caroline S. E. Homer
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC, Australia,Faculty of Health, Universityof Technology Sydney, Sydney, NSW, Australia,Correspondence: Caroline S. E. Homer
| | - Nasrin Javid
- Faculty of Health, Universityof Technology Sydney, Sydney, NSW, Australia,Nursing and Midwifery Research Alliance, South West Sydney Local Health District, Liverpool, NSW, Australia
| | - Kellie Wilton
- Australian College of Midwives, Canberra, ACT, Australia
| | - Zoe Bradfield
- Faculty of Health Sciences, King Edward Memorial Hospital and Curtin University, Perth, WA, Australia
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Geoghegan S, Shuster S, Butler KM, Feemster KA. Understanding Barriers and Facilitators to Maternal Immunization: A Systematic Narrative Synthesis of the Published Literature. Matern Child Health J 2022; 26:2198-2209. [PMID: 36173503 PMCID: PMC9521012 DOI: 10.1007/s10995-022-03508-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 11/24/2022]
Abstract
Introduction Vaccines are being developed against Group B Streptococcus and respiratory syncytial virus. These vaccines are designed to be given to pregnant women to protect infants; thus, their success depends on uptake in this population. Maternal immunization programs have struggled to achieve target coverage rates. This systematic narrative synthesis aims to define the most important barriers and facilitators for maternal immunization and to identify priority areas for future research. Methods A search strategy was developed in Medline and adapted according to the requirements of additional search engines. Two reviewers independently reviewed the studies, using pre-specified inclusion and exclusion criteria. Results sections of included studies were coded, and thematic analysis was used to identify prominent themes. Results 321 studies were included in the final review. Most studies came from North America (37%), Europe (26%) or East Asia, Australia and New Zealand (22%). Low-and middle-income countries were under-represented. Five percent of studies came from Sub-Saharan Africa, and 2% came from South Asia. The prominent factors impacting maternal immunization were provider recommendation, perceived risks and benefits of maternal vaccines for the infant, race, birthplace, and access to healthcare. Few studies explored reasons behind racial and socioeconomic disparities in maternal immunization rates. Discussion A strong provider recommendation, equitable access to prenatal care and messaging that focuses on vaccine safety and infant benefits emerged as the key components for optimising vaccine uptake among pregnant women. Research among healthcare providers, minority groups and in low- and-middle-income countries was lacking. In anticipation of the expansion of maternal immunization programmes, focused research is needed to address these gaps and inform a successful public health strategy. Supplementary Information The online version contains supplementary material available at 10.1007/s10995-022-03508-0.
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Affiliation(s)
- Sarah Geoghegan
- Division of Infectious Diseases, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA. .,University College Dublin School of Medicine, Belfield, Dublin 4, Ireland.
| | - Sydney Shuster
- Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
| | - Karina M Butler
- University College Dublin School of Medicine, Belfield, Dublin 4, Ireland.,Children's Health Ireland at Crumlin, Dublin 12, Ireland
| | - Kristen A Feemster
- Division of Infectious Diseases, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd., Building 421, Philadelphia, PA, 19104, USA.,Global Medical and Scientific Affairs, Merck Research Laboratories, Merck & Co., Inc, 351 North Sumneytown Pike, Upper Gwynedd, PA, 19454, USA
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6
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Bernstein HH, Tong-Miller S, Cleary SS, Sherin M, Spino C. Factors Influencing Maternal Antepartum Tdap Vaccination. Matern Child Health J 2022;:1-11. [PMID: 36173502 DOI: 10.1007/s10995-022-03557-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2022] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Antepartum Tdap remains low despite national recommendations. This prospective observational study aims to identify factors associated with lower antepartum Tdap rates. METHODS Maternal demographics, personal health beliefs, Tdap vaccination status, and recall of in-office obstetric provider actions were collected from a convenience sample of postpartum women in a New York metropolitan hospital. Bivariate and multivariable logistic regression were used to identify significant factors and adjusted odds ratios (OR) for recorded Tdap; OR > 1 reflects elements with increased odds of not receiving antepartum Tdap, while OR < 1 demonstrates increased odds of receipt. RESULTS Surveys were collected (n = 1682) from a study population demographically similar to New York City and more diverse in race/ethnicity than the national population. Demographic analysis showed Hispanic women less likely than white, non-Hispanic women to vaccinate (OR 2.44, CI 1.54-3.88). Health beliefs associated with non-receipt of antepartum Tdap included "It is dangerous for pregnant women to get vaccines" (OR 1.68, CI 1.01-2.77), and "I worry about the safety of the Tdap vaccine" (OR 1.59, CI 1.12-2.24). Obstetric provider actions associated with vaccination included receiving an OB recommendation (OR 0.39, CI 0.23-0.65), getting written information about Tdap (OR 0.44, CI 0.30-0.64), and having Tdap offered in office (OR 0.24, CI 0.15-0.37). Health beliefs associated with antepartum Tdap included "I generally do what my OB/GYN provider recommends" (OR 0.49, CI 0.30-0.80), and "Pregnant women should get the Tdap (pertussis) vaccine" (OR 0.17, CI 0.09-0.33). DISCUSSION Maternal race/ethnicity, personal health beliefs, and obstetric provider actions predict antepartum Tdap.
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Laurie L, Lambert SB, Jones L, Boddy G, O'Grady KAF. Influenza and pertussis vaccine uptake during pregnancy among Australian women in south-east Queensland, Australia. Aust N Z J Public Health 2021; 45:443-448. [PMID: 34181299 DOI: 10.1111/1753-6405.13133] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 04/01/2021] [Accepted: 05/01/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Population-specific studies of vaccine uptake in pregnancy are necessary to monitor progress and ensure enablers to vaccination are locally relevant. We aimed to determine the uptake of influenza and pertussis vaccine during pregnancy in women in south-east Queensland and the reasons why women were choosing not to vaccinate. METHODS A secondary analysis of data collected in a prospective cohort study. Data were collected at enrolment during pregnancy and within six weeks of giving birth. The primary outcome was the proportion of women vaccinated during pregnancy. RESULTS Among 310 pregnant women, 45.8% and 69.7% were vaccinated against influenza and pertussis, respectively; 123 (39.7%) had received both vaccines. The common predictor of vaccine uptake for influenza, pertussis or both was having had any vaccine in the 12 months prior to pregnancy. Not considering the vaccines necessary and perceptions of the risk of infection were common reasons for not intending to vaccinate. CONCLUSIONS Antenatal vaccine uptake remains suboptimal in women in south-east Queensland. Barriers to vaccination during pregnancy are complex and vary depending on context and population. Implications for public health: More efforts are needed to promote antenatal uptake, particularly for influenza vaccine and having both the influenza and pertussis vaccines during pregnancy.
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Affiliation(s)
- Lucy Laurie
- Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, Queensland University of Technology, Queensland
| | - Stephen B Lambert
- Queensland Health - Communicable Diseases Branch, Queensland.,National Centre for Epidemiology and Population Health, Australian National University, Australian Capital Territory
| | - Lee Jones
- Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, Queensland University of Technology, Queensland
| | - Gary Boddy
- Queensland Health - Communicable Diseases Branch, Queensland
| | - Kerry-Ann F O'Grady
- Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, Queensland University of Technology, Queensland
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Mazzilli S, Tavoschi L, Lopalco PL. Knowledge, attitudes and practices concerning pertussis maternal immunization in a sample of Italian gynaecologists. Hum Vaccin Immunother 2021; 17:1681-1685. [PMID: 33499709 DOI: 10.1080/21645515.2020.1833580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Infants are at risk of developing serious diseases as a consequence of pertussis infection. Thus, to protect newborns, many countries, including Italy, have introduced pertussis maternal immunization. However, despite the compelling evidence supporting Tdap vaccinations, the rates of coverage among Italian pregnant women have remained consistently very low. Numerous studies have shown that healthcare providers' recommendations are critical for achieving high maternal vaccination coverages. This study explores Italian gynecologists' knowledge, attitude and practices concerning pertussis maternal immunization. Between July 2018 and September 2018, we performed a national cross-sectional survey administered by e-mail using the mailing list of the Association of Italian Hospital Obstetricians and Gynecologists (AOGOI): the mailing list included more than 3500 members. A total of 451 respondents distributed throughout Italy completed the online survey. Overall, 275 (60.97%) respondents did not routinely recommend pertussis vaccination to pregnant women, mainly for suboptimal knowledge of the maternal pertussis vaccine, protocols, and guidelines: furthermore, 15.44% (69/447) of gynecologists were not aware of the pertussis vaccination program for pregnant women. Gynecologists working in the South or in the Islands of Italy were less aware about the need of administering Tdap in expectant mothers, suggesting that there is a potential risk of health inequalities based on differing levels of vaccine knowledge and recommendations across Italy. In order to enable healthcare professionals to provide accurate and timely information on pertussis immunization to pregnant women, targeted educational programs to improve gynecologists' knowledge on pertussis vaccination are needed.
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Affiliation(s)
- Sara Mazzilli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.,Scuola Normale Superiore, Pisa, Italy
| | - Lara Tavoschi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Pier Luigi Lopalco
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
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Bucchiotty M, El Morabit S, Hammou Y, Gallouj R, Messaadi N, Vanderstichele S, Roumilhac M, Dufour P, Subtil D. Effect of a postpartum prescription for pertussis vaccine: a before-and-after study. J Gynecol Obstet Hum Reprod 2021; 50:102050. [PMID: 33421623 DOI: 10.1016/j.jogoh.2020.102050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/23/2020] [Accepted: 12/27/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Among the strategies to encourage pregnant women to be vaccinated against pertussis in the postpartum period, that of giving them a prescription has been evaluated only sparsely. OBJECTIVE To measure the effect of giving women who are not immunized against pertussis a prescription for the vaccine at discharge from the maternity unit. MATERIAL AND METHODS Single-center before-and-after study (2011: before; 2015: after). All women received both oral and written information about vaccination against pertussis. During the after period, they were also specifically asked their immunization status during pregnancy. Those currently unimmunized received a written prescription for it at discharge. RESULTS Among the women unimmunized at delivery, the percentage who were vaccinated postpartum climbed from 17 to 42% between 2011 and 2015 (p < 0.001), while the percentage of their unimmunized partners who were vaccinated remained stable (27 and 29%, p = 0.74). During this time, the percentage of women immunized against pertussis at the beginning of pregnancy rose from 32 to 52% (p < 0.001). Finally, the percentage of all women protected against this disease postpartum climbed from 44 to 72% between these two periods (p < 0.001). CONCLUSIONS In the postpartum period, giving a prescription for pertussis vaccine to women unimmunized is accompanied by a significant elevation in their vaccination rate. Nevertheless, this rate remains low and better strategies have to be implemented.
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Affiliation(s)
- Marion Bucchiotty
- Univ. Lille, CHU Lille, Hôpital Jeanne de Flandre, F-59000 Lille, France.
| | - Saliha El Morabit
- Univ. Lille, CHU Lille, Hôpital Jeanne de Flandre, F-59000 Lille, France
| | - Yamina Hammou
- Univ. Lille, CHU Lille, Hôpital Jeanne de Flandre, F-59000 Lille, France
| | - Rachida Gallouj
- Univ. Lille, CHU Lille, Hôpital Jeanne de Flandre, F-59000 Lille, France
| | - Nasser Messaadi
- Univ. Lille, Département de Médecine Générale, F-59000 Lille, France
| | | | - Marielle Roumilhac
- Univ. Lille, CHU Lille, Hôpital Jeanne de Flandre, F-59000 Lille, France
| | - Philippe Dufour
- Univ. Lille, CHU Lille, Hôpital Jeanne de Flandre, F-59000 Lille, France
| | - Damien Subtil
- Univ. Lille, CHU Lille, Hôpital Jeanne de Flandre, F-59000 Lille, France; Univ. Lille, EA 2694 Santé Publique, Épidémiologie et Qualité des Soins, F-59000 Lille, France
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Goggins ER, Williams R, Kim TG, Adams JC, Davis MJ, McIntosh M, Uzor M, Geary F, Jamieson DJ, Boulet SL. Assessing Influenza Vaccination Behaviors Among Medically Underserved Obstetric Patients. J Womens Health (Larchmt) 2020; 30:52-60. [PMID: 33095095 DOI: 10.1089/jwh.2020.8582] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Despite recommendations, maternal influenza vaccine acceptance has stagnated around 50%. Materials and Methods: A prospective cohort study was conducted of pregnant women seen in the clinic from September 2018 to April 2019. Primary outcomes included influenza vaccine uptake and reasons for vaccine refusal, categorized based on the Health Belief Model. We compared characteristics between three vaccination groups (never refused, refused and vaccinated, and refused and not vaccinated) by using chi-square and one-way analysis of variance. We used multivariate logistic regression to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for associations between patient characteristics and vaccine acceptance. Mixed-effects logistic regression models were used to explore the impact of provider-patient race concordance on influenza vaccine uptake. Results: Among 1666 women, 902 (54.1%) were vaccinated. Of these, 183 (20.3%) initially refused. Those who refused and were never vaccinated were more likely to be non-Hispanic black (aOR: 1.64, 95% CI: 1.05-2.56) and less likely to be Hispanic (aOR: 0.44, 95% CI: 0.24-0.81). Overall, perceived barriers were the most common reason for refusal (52.4%). Women who refused consistently were more likely to cite reasons related to perceived benefits (38.5% vs. 7.6%). Those who eventually accepted were more likely to cite cue to action (22.4% vs. 12.6%). Women who were race discordant with their provider were more likely to be vaccinated compared with those who were race concordant (57.9% vs. 52.9%, aOR: 1.16, 95% CI: 1.07-1.27). Conclusions: Women who refuse influenza vaccination in pregnancy may later choose to be vaccinated. Continued promotion of vaccination throughout pregnancy is crucial for vaccine uptake.
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Affiliation(s)
- Emily R Goggins
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Rachel Williams
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Tesia G Kim
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Jenna C Adams
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Miah J Davis
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Michelle McIntosh
- Department of Obstetrics and Gynecology, Grady Health System, Atlanta, Georgia, USA
| | - Michelle Uzor
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, Atlanta, Georgia, USA
| | - Franklyn Geary
- Department of Obstetrics and Gynecology, Morehouse School of Medicine, Atlanta, Georgia, USA
| | - Denise J Jamieson
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Sheree L Boulet
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, Georgia, USA
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Tuckerman JL, Kaufman J, Danchin M, Marshall HS. Influenza vaccination: A qualitative study of practice level barriers from medical practitioners caring for children with special risk medical conditions. Vaccine 2020; 38:7806-7814. [PMID: 33164803 DOI: 10.1016/j.vaccine.2020.10.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 10/03/2020] [Accepted: 10/07/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Understanding the influenza vaccination practices of general practitioners (GP) and paediatric hospital specialists caring for children with special risk medical conditions (SRMC) is imperative for designing interventions to improve uptake. This study aimed to identify the vaccination decision making, provider practices and perceived barriers and facilitators to recommending or delivering influenza vaccine for children with SRMCs at the tertiary and primary care levels. METHODS Nominated GPs and hospital specialists from a single tertiary hospital were interviewed to explore influenza vaccination practices and challenges for children with confirmed SRMCs. Interviews were digitally recorded, transcribed verbatim and thematic analysis was used to inductively code these data. Resulting themes were mapped across the COM-B ('capability', 'opportunity', 'motivation' and 'behaviour') theoretical framework to understanding barriers and potential interventions. RESULTS Twenty-six medical practitioners (21 GPs and 5 hospital specialists) completed semi-structured interviews. Barriers, and facilitators for influenza vaccine recommendation (the intended behaviour) were thematically grouped. Opportunity themes included structural barriers (e.g. limited use of systems and processes to support the identification of children with SRMCs); recommendation as standard practice; vaccination inconvenience; lack of communication and educational resources; social acceptance and normalisation; and media messaging. Capability themes included provider communication with parents; knowledge of influenza vaccine recommendations; and professional boundaries to implement the recommendation. Themes in the Motivation category included provider clinical prioritisation and responsibility towards providing a recommendation. CONCLUSIONS The main barriers to influenza recommendation raised by our study participants were structural. These included lack of processes to identify children with SRMCs, limited use of reminder systems and unclear delineation of role responsibility between hospital specialists and GPs. An important driver that emerged was GPs' responsibility for providing a recommendation. To increase influenza vaccine coverage for children with SRMCs, consideration should be given to addressing practice level structural barriers and improving collaboration.
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Affiliation(s)
- Jane L Tuckerman
- Adelaide Medical School, University of Adelaide, South Australia, Australia; Murdoch Children's Research Institute, Melbourne, Australia; Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Melbourne, Australia
| | - Jessica Kaufman
- Murdoch Children's Research Institute, Melbourne, Australia; Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Melbourne, Australia
| | - Margie Danchin
- Murdoch Children's Research Institute, Melbourne, Australia; Royal Children's Hospital, Melbourne, Australia; University of Melbourne, Melbourne, Australia
| | - Helen S Marshall
- Adelaide Medical School, University of Adelaide, South Australia, Australia; Vaccinology and Immunology Research Trials Unit, Women's and Children's Hospital, North Adelaide, South Australia, Australia; Robinson Research Institute, University of Adelaide, South Australia, Australia; South Australian Health and Medical Research Institute.
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12
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Wilcox CR, Little P, Jones CE. Current practice and attitudes towards vaccination during pregnancy: a survey of GPs across England. Br J Gen Pract 2020; 70:e179-e185. [PMID: 31988088 PMCID: PMC6988681 DOI: 10.3399/bjgp20x708113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 07/22/2019] [Indexed: 10/31/2022] Open
Abstract
Background Antenatal vaccines are commonly delivered in primary care, yet the views of GPs regarding these programmes have been neglected in research to date. Aim To establish the attitudes and current practice of GPs towards antenatal vaccination and their views on the optimal location for delivery of this service. Design and setting A multicentre online survey questionnaire. Method A questionnaire was sent to GPs across England between December 2018 and January 2019. Results The majority of 1586 responders considered antenatal vaccination safe (96% for influenza, 89% pertussis). GPs were significantly less confident in their knowledge of pertussis compared with influenza vaccination (64% versus 80% were confident, P <0.001), and many desired further education (59% versus 48%, P <0.001). Few (37%) discussed vaccination with pregnant women regularly, but most (80%) felt their recommendation would influence decision making. Those with greater confidence in their knowledge of pertussis and influenza vaccination, and who were >2 years since qualifying, discussed vaccination significantly more often (odds ratio [OR] 3.52, P <0.001; OR 2.34, P = 0.001; OR 1.76, P = 0.003, respectively), regardless of whether they routinely saw pregnant women. Most (83%) reported that antenatal vaccination was GP led in their region, yet only 26% thought it should be primarily GP based. GPs expressed disconnect from antenatal care, and many suggested that midwives and/or secondary care should take greater responsibility for the delivery of antenatal vaccination. Conclusion There is support among GPs to embed vaccination programmes within routine antenatal care. Further educational resources, specifically designed for the needs of GPs, are needed to facilitate opportunistic discussion with pregnant women about vaccination.
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Affiliation(s)
- Christopher R Wilcox
- NIHR Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton
| | - Paul Little
- Department of Primary Care and Population Sciences, Aldermoor Health Centre, University of Southampton, Southampton
| | - Christine E Jones
- Faculty of Medicine and Institute for Life Sciences, University of Southampton; University Hospital Southampton NHS Foundation Trust, Southampton
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13
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Brillo E, Tosto V, Giardina I, Buonomo E. Maternal tetanus, diphtheria, and acellular pertussis (Tdap) and influenza immunization: an overview. J Matern Fetal Neonatal Med 2019; 34:3415-3444. [PMID: 31645152 DOI: 10.1080/14767058.2019.1680633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND Maternal tetanus, diphtheria, and acellular pertussis (Tdap) and influenza immunization for women during pregnancy (the so-called "maternal immunization") has been introduced in several countries, and recently also in Italy, to protect mother and fetus during pregnancy, infant in his first months of life and mother during postpartum period. However, very low vaccination coverage rates have been reached due to several variables. METHODS A literature search was conducted on PubMed and Embase, including any experimental or observational studies, to assesses existing evidence on the effectiveness, efficacy, safety and optimal timing of administration of Tdap and influenza immunization in pregnancy for mothers and their infants. The search was finalized in August 2019. RESULTS Reviewing the literature, we identified only a few studies that, among several maternal and infant outcomes, found sporadic significant associations with maternal influenza immunization and even less with Tdap immunization. Moreover, most of the authors of these studies explained these findings as a result of residual confounding effect. The effectiveness of maternal influenza immunization is more complicated to prove than the effectiveness of Tdap immunization because of several reasons. Not all nations recommend and offer vaccines in the same weeks of pregnancy and this one manifests the complexity in defining the best timing for Tdap or influenza immunization. CONCLUSIONS The safety of maternal Tdap or influenza immunization is supported by the evidence so far, however, regular surveillance should be maintained, especially with regard to the influenza vaccine that changes in formulation each year. There is a need to optimize the timing of vaccination in pregnancy and to have a national system of detection of maternal immunization in each country.
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Affiliation(s)
- Eleonora Brillo
- Center for Research in Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Valentina Tosto
- Department of Obstetrics and Gynecology, University Hospital of Perugia, Perugia, Italy
| | - Irene Giardina
- Center for Research in Perinatal and Reproductive Medicine, University of Perugia, Perugia, Italy.,Department of Obstetrics and Gynecology, University Hospital of Perugia, Perugia, Italy
| | - Ersilia Buonomo
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
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Carlson SJ, Scanlan C, Marshall HS, Blyth CC, Macartney K, Leask J. Attitudes about and access to influenza vaccination experienced by parents of children hospitalised for influenza in Australia. Vaccine 2019; 37:5994-6001. [PMID: 31471153 DOI: 10.1016/j.vaccine.2019.08.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 07/23/2019] [Accepted: 08/15/2019] [Indexed: 12/16/2022]
Abstract
INTRODUCTION In Australia, influenza hospitalises more children than any other vaccine preventable disease does. Children aged six months or older are recommended to receive annual influenza vaccines, and pregnant women are recommended vaccination to protect infants aged up to six months. However, vaccine uptake is low. This study explored influenza vaccination knowledge and behaviours of parents of children who were hospitalised for influenza, in order to inform strategies that target barriers to uptake. METHODS We conducted 27 semi-structured interviews with parents/caregivers during or shortly after their child's hospitalisation for laboratory-confirmed influenza in 2017. Questions were guided by the Social Ecological Model exploring all levels of influence on vaccination uptake from the intrapersonal through to policy, via the parents' perspective. Transcripts were inductively analysed. Themes were categorised into the components of the Capability-Opportunity-Motivation-Behaviour (COM-B) model. RESULTS 20/27 children were aged six months or older; 16/20 had not received an influenza vaccine in 2017. Mothers of 4/7 infants aged less than six months were not vaccinated in pregnancy. The themes regarding barriers to influenza vaccination were: (1) Limited Capability - misinterpretations and knowledge gaps, (2) Lack of Opportunity - inconvenient vaccination pathway, missing recommendations, absence of promotion to all, and the social norm, and (3) Missing Motivation - hierarchy of perceived seriousness, safety concerns, a preference for 'natural' ways. Though most parents, now aware of the severity of influenza, intended to vaccinate their child in future seasons, some harboured reservations about necessity and safety. When parents were asked how to help them vaccinate their children, SMS reminders and information campaigns delivered through social media, schools and childcare were suggested. CONCLUSION Improving parents' and providers' knowledge and confidence in influenza vaccination safety, efficacy, and benefits should be prioritised. This, together with making influenza vaccination more convenient for parents, would likely raise vaccine coverage.
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Affiliation(s)
- Samantha J Carlson
- The University of Sydney, School of Public Health, Sydney, New South Wales 2006, Australia.
| | - Camilla Scanlan
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales 2145, Australia; The University of Sydney, Sydney Health Ethics, Sydney, NSW 2006, Australia.
| | - Helen S Marshall
- Robinson Research Institute and Adelaide Medical School, University of Adelaide and Women's and Children's Health Network, Adelaide, South Australia 5006, Australia.
| | - Christopher C Blyth
- Discipline of Paediatrics, School of Medicine and Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, GPO Box D184, Perth, Western Australia 6840, Australia; Perth Children's Hospital, Hospital Avenue, Nedlands, Western Australia 6009, Australia.
| | - Kristine Macartney
- National Centre for Immunisation Research and Surveillance, Westmead, New South Wales 2145, Australia; The University of Sydney, Discipline of Child and Adolescent Health, Sydney, New South Wales 2006, Australia.
| | - Julie Leask
- The University of Sydney, Susan Wakil School of Nursing and Midwifery, 88 Mallett St, Camperdown, New South Wales 2006, Australia.
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Doraivelu K, Boulet SL, Biswas HH, Adams JC, Haddad LB, Jamieson DJ. Predictors of tetanus, diphtheria, acellular pertussis and influenza vaccination during pregnancy among full-term deliveries in a medically underserved population. Vaccine 2019; 37:6054-6059. [PMID: 31471152 DOI: 10.1016/j.vaccine.2019.08.044] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 08/14/2019] [Accepted: 08/19/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate predictors of vaccination among women who received tetanus, diphtheria, and acellular pertussis vaccination (Tdap), influenza vaccination, and Tdap and influenza vaccinations. STUDY DESIGN In a retrospective cohort study of all full-term (≥37 weeks gestation) deliveries between July 1, 2016 and June 30, 2018 at a single, safety-net institution, we used multinomial logistic regression models to compare predictors of vaccination among women who received Tdap only, influenza only, and both Tdap and influenza vaccines. RESULTS Among 3132 full-term deliveries, women were primarily non-Hispanic black (67.5%), between the ages of 21-34 (65.3%), and multiparous (76.0%). The rates of only influenza or Tdap vaccination were 10.3% and 21.6%, respectively; 43.3% of women received both vaccines, and 24.9% of women did not receive either vaccine. In the adjusted models, Hispanic ethnicity was positively associated with receipt of all types of vaccination and non-Spanish language interpreter use was positively associated with receipt of Tdap vaccination and Tdap and influenza vaccination. A parity of greater than three and inadequate and unknown prenatal care adequacy were negative predictors of all types of vaccination. Pre-existing hypertension was negatively associated with Tdap vaccination, and HIV-positive status was negatively associated with influenza vaccination and Tdap and influenza vaccination. CONCLUSION Compared to the national rate of both Tdap and influenza vaccination (32.8%), a higher proportion of women received both vaccines in our study population. Vaccine uptake may be affected by race/ethnicity, use of interpreter services, parity, pre-existing comorbidities, and prenatal care adequacy. The lower rate of influenza vaccination compared to Tdap vaccination suggests that other factors, such as vaccine hesitancy and mistrust, may be differentially impacting influenza vaccination uptake in our predominantly minority population. Future provider and public health approaches to vaccine promotion should incorporate culturally appropriate strategies that address vaccine-related beliefs and misconceptions.
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Affiliation(s)
- Kamini Doraivelu
- Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA 30322, United States
| | - Sheree L Boulet
- Department of Gynecology and Obstetrics, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Atlanta, GA 30303, United States
| | - Hope H Biswas
- Department of Gynecology and Obstetrics, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Atlanta, GA 30303, United States
| | - Jenna C Adams
- Emory University School of Medicine, 201 Dowman Dr, Atlanta, GA 30322, United States
| | - Lisa B Haddad
- Department of Gynecology and Obstetrics, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Atlanta, GA 30303, United States
| | - Denise J Jamieson
- Department of Gynecology and Obstetrics, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Atlanta, GA 30303, United States.
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McHugh L, Crooks K, Creighton A, Binks M, Andrews RM. Safety, equity and monitoring: a review of the gaps in maternal vaccination strategies for Aboriginal and Torres Strait Islander women. Hum Vaccin Immunother 2019; 16:371-376. [PMID: 31368832 DOI: 10.1080/21645515.2019.1649552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Influenza and pertussis infections are disproportionately higher among Aboriginal and Torres Strait Islander women and their infants compared to other Australians. These infections are potentially preventable through vaccination in pregnancy; however, there is a lack of systematic monitoring and therefore knowledge of vaccine uptake, safety and effectiveness in Australia, and specifically among Aboriginal and Torres Strait Islander women. The limited data available suggest there is a lower uptake of maternal vaccination among Aboriginal and Torres Strait Islander women compared to non-Aboriginal and Torres Strait Islander women, and this review seeks to explore potential reasons and the knowledge gaps in this regard. Other key gaps include the equitable access to quality antenatal care for Aboriginal and Torres Strait Islander women; and pregnancy loss <20 weeks gestation. Furthermore, our review highlights the importance of addressing these gaps in maternal vaccination strategies in partnership with Aboriginal and Torres Strait Islander peoples.
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Affiliation(s)
- Lisa McHugh
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia
| | - Kristy Crooks
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia.,Hunter New England Local Health District, Population Health, Wallsend, New South Wales, Australia
| | - Amy Creighton
- Hunter New England Local Health District, Population Health, Wallsend, New South Wales, Australia
| | - Michael Binks
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia
| | - Ross M Andrews
- Menzies School of Health Research, Charles Darwin University, Tiwi, Northern Territory, Australia.,Department of Population Health, National Centre for Epidemiology, Australian National University, Canberra, Australian Capital Territory, Australia
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Ledent E, Gabutti G, de Bekker-Grob EW, Alcázar Zambrano JL, Campins Martí M, Del Hierro Gurruchaga MT, Fernández Cruz MJ, Ferrera G, Fortunato F, Torchio P, Zoppi G, Agboton C, Kandeil W, Marchetti F. Attributes influencing parental decision-making to receive the Tdap vaccine to reduce the risk of pertussis transmission to their newborn - outcome of a cross-sectional conjoint experiment in Spain and Italy. Hum Vaccin Immunother 2019; 15:1080-1091. [PMID: 30735474 PMCID: PMC6605846 DOI: 10.1080/21645515.2019.1571890] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Pertussis vaccination of parents and household contacts (‘cocooning’) to protect newborn infants is an established strategy in many countries, although uptake may be low. Many aspects may influence such decision-making. We conducted a cross-sectional survey (NCT01890447) of households and other close contacts of newborns aged ≤6 months (or of expectant mothers in their last trimester) in Spain and Italy, using an adaptive discrete-choice experiment questionnaire. Aims were to assess the relative importance of attributes influencing vaccine adoption, and to estimate variation in vaccine adoption rates and the impact of cost on vaccination rates. Six hundred and fifteen participants (Spain, n = 313; Italy, n = 302) completed the survey. Of 144 available questionnaire scenarios, the most frequently selected (14% of respondents in both countries) were infant protection by household vaccination at vaccination center, recommendation by family physician and health authorities, with information available on leaflets and websites. The attribute with highest median relative importance was ‘reduction in source of infection’ in Spain (23.1%) and ‘vaccination location’ in Italy (18.8%). Differences between other attributes were low in both countries, with media attributes showing low importance. Over 80% of respondents indicated a definite or probable response to vaccine adoption (at no-cost) with estimated probability of adoption of 89–98%; applying vaccine costs (25€ per person) would reduce the probability of uptake by 7–20% in definite/probable respondents. Awareness of these determinants is helpful in informing Health Authorities and healthcare practitioners implementing a cocooning strategy for those populations where maternal immunization is not a preferred option.
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Affiliation(s)
- Edouard Ledent
- a Statistical Solutions & Innovations , GSK , Rixensart , Belgium
| | - Giovanni Gabutti
- b Department of Medical Sciences , University of Ferrara , Ferrara , Italy
| | - Esther W de Bekker-Grob
- c Section Health Technology Assessment and Erasmus Choice Modelling Centre , Erasmus School of Health Policy & Management, Erasmus University Rotterdam , Rotterdam , The Netherlands
| | | | - Magda Campins Martí
- e Servicio de Medicina Preventiva y Epidemiología , Hospital Universitario Vall d'Hebron , Barcelona , Spain
| | | | | | - Giuseppe Ferrera
- i Dipartimento Medico di Prevenzione-Servizio Epidemiologia , ASP Ragusa, Centro Servizi , Ragusa , Italy
| | - Francesca Fortunato
- j Department of Medical and Surgical Sciences , University of Foggia , Foggia , Italy
| | | | - Giorgio Zoppi
- l Dipartimento di Prevenzione , Struttura Complessa Igiene e Sanità Pubblica , Chiavari , Regione Liguria , Italy
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Erb ML, Erlanger TE, Heininger U. Child-parent immunization survey: How well are national immunization recommendations accepted by the target groups? Vaccine X 2019; 1:100013. [PMID: 31384735 PMCID: PMC6668236 DOI: 10.1016/j.jvacx.2019.100013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 01/05/2019] [Accepted: 02/06/2019] [Indexed: 12/30/2022] Open
Abstract
Most of the time gynecologists had not recommended vaccinations to pregnant women. Only 3% of mothers were vaccinated against pertussis and influenza in pregnancy. Misconceptions led to non-compliance of pregnant women with recommended vaccinations.
Background Pertussis disease rates are high in Switzerland, especially in infants and young infants. To protect newborns from this serious disease, EKIF, the Swiss National Immunization Technical Advisory Group, has recommended vaccination against pertussis during pregnancy (2nd or 3rd trimester) since 2013. Also, since 2009, EKIF has recommended vaccination against influenza during pregnancy. We conducted this study to assess acceptance and implementation of these recently introduced recommendations. Methods We performed standardized interviews with parents of children born on or after 01.01.2013, hospitalized at the University of Basel Children’s Hospital, Switzerland, between January and June 2017. If participation was declined, partial consent was sought for four questions regarding age, education level, attitudes towards vaccinations in general and availability of vaccination records. Results In 193 of 398 eligible children the mother participated. Five (3%) of 172 mothers had received both pertussis and influenza vaccines during pregnancy, 15 (9%) only against pertussis and 12 (7%) only against influenza. Very few mothers had received vaccination recommendation during pregnancy: 17 (10%) for both pertussis and influenza and 15 (9%) each for pertussis and influenza only. Main reasons for refusal of vaccination despite recommendation were that they were not deemed useful (59% for influenza and 37% for pertussis) and safety concerns for the child (18% for influenza and 26% for pertussis). Conclusions Recommendation for and immunization rates against pertussis and influenza during pregnancy are low and need to be improved. As recommendations from health care personnel have been shown to have the most significant impact on immunization rates, we propose to focus on improving awareness and acceptance for immunization in pregnancy among health care personnel involved in the care of pregnant women.
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Affiliation(s)
- M L Erb
- University of Basel Children's Hospital, Department of Infectious Diseases and Vaccinology, CH-4056 Basel, Switzerland
| | - T E Erlanger
- University of Basel, University Hospital Basel, Department of Clinical Research, Clinical Trial Unit, CH-4056 Basel, Switzerland
| | - U Heininger
- University of Basel Children's Hospital, Department of Infectious Diseases and Vaccinology, CH-4056 Basel, Switzerland
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Meng QH, Luo J, Yang F, Shen YJ, Li L, Li LJ, Shi W, Wang YJ, Yao KH. A General Lack of IgG Against Pertussis Toxin in Chinese Pregnant Women and Newborns. Pediatr Infect Dis J 2018; 37:934-8. [PMID: 29406469 DOI: 10.1097/INF.0000000000001933] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND To investigate the level of pertussis-related antibodies in pregnant women and newborns. METHODS A total of 286 serum samples from healthy pregnant women and 221 cord samples from newborns were collected in 2016 in Beijing. A routine blood sample from pregnant women was obtained at 35 weeks of gestational age, and cord samples were collected in 20 minutes after delivery. The values from cord samples were used as the infant values. Anti-pertussis toxin (PT) IgG concentration was measured by ELISA (Euroimmun, Lübeck, Germany) using purified PT as a coating antigen. Newborns with anti-PT IgG ≤40 IU/mL in cord samples were considered to be unprotected against pertussis. Anti-PT IgG ≥100 IU/mL was considered to be indicative of a recent pertussis infection in pregnant women. RESULTS The anti-PT IgG concentration below the lower limit of detection (<5 IU/mL) occurred in 74.1% (212/286) of pregnant women and 66.5% (147/221) of newborns. Even with detectable anti-PT antibodies, the majority of pregnant women (79.7%, 59/74) and newborns (73.0%, 54/74) had antibody level of 5 to <20 IU/mL, and 13.5% (10/74) of pregnant and 14.9% (11/74) of newborns had antibody level of 20 to <40 IU/mL. The 75% percentiles for anti-PT IgG of pregnant women and newborns were 5.08 and 6.98 IU/mL, respectively. The prevalence of unprotected newborns as defined by anti-PT IgG ≤40 IU/mL was 95.9% (202/211). The prevalence of recent pertussis infection in pregnant women as defined by anti-PT IgG ≥100 was 0.7% (2/286). CONCLUSIONS The pregnant women and newborns were generally lack of protective antibody and are vulnerable to pertussis in Beijing, China. Although acellular pertussis vaccine is administrated in infancy in China, a booster vaccination to pregnant women should be considered for protecting young infants who are too young to start pertussis vaccination.
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Mohammed H, Clarke M, Koehler A, Watson M, Marshall H. Factors associated with uptake of influenza and pertussis vaccines among pregnant women in South Australia. PLoS One 2018; 13:e0197867. [PMID: 29902184 PMCID: PMC6002099 DOI: 10.1371/journal.pone.0197867] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 05/09/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Maternal immunization is an effective strategy to protect pregnant women and their infants from vaccine-preventable diseases. Despite the recommendation of maternal influenza and more recently pertussis immunization in Australia, uptake of these vaccines has been suboptimal. A midwife delivered immunization program for pregnant women at the Women's and Children's Hospital in South Australia commenced in April 2015. Monitoring the uptake of the current funded vaccine programs for pregnant women is limited. The study aimed to estimate maternal vaccine uptake and assess factors associated with influenza and pertussis vaccine uptake among pregnant women. METHODS This prospective study was undertaken between November 2014 and July 2016 at the Women's and Children's Hospital. Following consent, demographic details and vaccination history for South Australian pregnant women who attended the antenatal clinic were collected. A standardised self-reported survey was completed during pregnancy with a follow up telephone interview at 8-10 weeks post-delivery. RESULTS 205 women consented and completed the self-reported survey. Of the 180 pregnant women who completed the study, 76% and 81% received maternal influenza and pertussis vaccines respectively. The adjusted odds of women receiving maternal vaccines during pregnancy were significantly higher for women delivering after the implementation of the midwife delivered program compared with women who delivered babies prior to the program for both pertussis vaccination (AOR 21.17, 95% CI 6.14-72.95; p<0.001) and influenza vaccination (AOR 5.95, 95% CI 2.13-16.61, p<0.001). Women receiving a recommendation from a health care provider and first time mothers were significantly more likely to receive influenza vaccination during pregnancy. CONCLUSIONS High uptake of influenza and pertussis vaccines during pregnancy can be attained with health care provider recommendation and inclusion of maternal immunization as part of standard antenatal care. A midwife delivered maternal immunization program is a promising approach to improve maternal vaccine uptake by pregnant women.
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Affiliation(s)
- Hassen Mohammed
- The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.,Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.,Vaccinology and Immunology Research Trials Unit (VIRTU), Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Michelle Clarke
- The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.,Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.,Vaccinology and Immunology Research Trials Unit (VIRTU), Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Ann Koehler
- The Communicable Disease Control Branch (CDCB), South Australia, Australia
| | - Maureen Watson
- The Communicable Disease Control Branch (CDCB), South Australia, Australia
| | - Helen Marshall
- The Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.,Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia.,Vaccinology and Immunology Research Trials Unit (VIRTU), Women's and Children's Hospital, North Adelaide, South Australia, Australia.,School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
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Bisset KA, Paterson P. Strategies for increasing uptake of vaccination in pregnancy in high-income countries: A systematic review. Vaccine 2018; 36:2751-9. [DOI: 10.1016/j.vaccine.2018.04.013] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 03/22/2018] [Accepted: 04/04/2018] [Indexed: 11/19/2022]
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Abstract
INTRODUCTION Pertussis is a highly contagious disease of the respiratory tract which is caused by the bacterium Bordetella pertussis and is most severe in those <1 year of age. A vaccine against pertussis, introduced in the 1950's, led to a significant decrease in incidence of the disease, but recent increases in outbreaks have been attributed to insufficient vaccine uptake, suboptimal protection conferred by vaccines, and waning immunity after immunization. Areas covered: In this review we discuss the major challenges for controlling pertussis, and what we believe the best strategies are to overcome these challenges, focusing on immunization against pertussis in Europe, but with recommendations that are relevant worldwide. Expert commentary: To provide maximum vaccine coverage we propose a schedule that incorporates immunization of infants, preschoolers, adolescents, adults, and pregnant women. Uptake of vaccines may also vary between populations due to a variety of causes, including hesitancy to vaccinate, so any national strategy to control pertussis should also include sustaining public and healthcare provider confidence in vaccination. Addressing and improving regional variations in surveillance will also help better monitor annual incidence and outbreaks. Looking towards the future, the development of new pertussis vaccines with longer duration of protection would be advantageous.
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Affiliation(s)
- Federico Martinón-Torres
- a Translational Pediatrics and Infectious Diseases , Hospital Clínico Universitario de Santiago , Santiago de Compostela , Spain.,b Genetics, Vaccines and Infectious Diseases Research Group (GENVIP), Instituto de Investigación Sanitaria de Santiago , Universidad de Santiago , Santiago de Compostela , Spain
| | - Ulrich Heininger
- c Pediatric Infectiology and Vaccination , University of Basel Children's Hospital (UKBB) , Basel , Switzerland
| | - Angus Thomson
- d Vaccine Confidence & Coverage, Public Affairs , Sanofi Pasteur , Lyon , France
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MacDougall DM, Halperin BA, Langley JM, McNeil SA, MacKinnon-Cameron D, Li L, Halperin SA. Knowledge, attitudes, beliefs, and behaviors of pregnant women approached to participate in a Tdap maternal immunization randomized, controlled trial. Hum Vaccin Immunother 2017; 12:879-85. [PMID: 27176822 PMCID: PMC4962967 DOI: 10.1080/21645515.2015.1130193] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Immunization with pertussis vaccine during pregnancy is recommended in a number of countries to prevent newborn deaths from whooping cough. In some jurisdictions, vaccine uptake during pregnancy is low. We undertook a survey of the knowledge, attitudes, beliefs, and behaviors of pregnant women who had been approached to participate in a randomized, controlled trial of tetanus-diphtheria-acellular pertussis (Tdap) vaccine during pregnancy. A total of 346 women completed the survey. Knowledge about pertussis and pertussis vaccine was generally low; the mean number of correct answers was 10.65 out of 19 questions. Attitudes toward maternal immunization were generally favorable; 51.7%–94.7% of women had positive responses to 10 attitudinal statements. Substantial uncertainty was shown in responses to a number of the attitudinal statements related to vaccination during pregnancy; 22.3%–45.7% neither agreed nor disagreed with the statements. Importantly, 89% of women reported that they would get immunized with pertussis vaccine during pregnancy if their physician recommended it. We conclude that a national recommendation to be immunized with pertussis vaccine during pregnancy supported by their physicians' recommendation would be well received by Canadian women.
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Affiliation(s)
- Donna M MacDougall
- a Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health Authority , Halifax , Nova Scotia , Canada.,b School of Nursing, St. Francis Xavier University , Antigonish , Nova Scotia , Canada
| | - Beth A Halperin
- a Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health Authority , Halifax , Nova Scotia , Canada.,c School of Nursing, Dalhousie University , Halifax , Nova Scotia , Canada.,d Department of Pediatrics , Dalhousie University , Halifax , Nova Scotia , Canada
| | - Joanne M Langley
- a Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health Authority , Halifax , Nova Scotia , Canada.,d Department of Pediatrics , Dalhousie University , Halifax , Nova Scotia , Canada.,e Department of Community Health and Epidemiology , Dalhousie University , Halifax , Nova Scotia , Canada
| | - Shelly A McNeil
- a Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health Authority , Halifax , Nova Scotia , Canada.,f Department of Medicine , Dalhousie University , Halifax , Nova Scotia , Canada
| | - Donna MacKinnon-Cameron
- a Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health Authority , Halifax , Nova Scotia , Canada
| | - Li Li
- a Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health Authority , Halifax , Nova Scotia , Canada
| | - Scott A Halperin
- a Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and Nova Scotia Health Authority , Halifax , Nova Scotia , Canada.,d Department of Pediatrics , Dalhousie University , Halifax , Nova Scotia , Canada.,g Department of Microbiology & Immunology , Dalhousie University , Halifax , Nova Scotia , Canada
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Ben Natan M, El Kravchenko B, Sakashidlo K, Mor S. What drives pregnant women's decisions to accept the pertussis vaccine? Appl Nurs Res 2017; 38:60-63. [PMID: 29241521 DOI: 10.1016/j.apnr.2017.09.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 09/23/2017] [Indexed: 10/18/2022]
Abstract
The aims of this study were to identify factors associated with pregnant women's intention to receive the pertussis vaccine during pregnancy, using the Health Belief Model; while comparing between pregnant native-born Israeli women and Israeli women born in the former Soviet Union. Convenience and snowball sampling methods were used to recruit 200 pregnant Israeli native-born women and women born in the former Soviet Union. Data were collected using a cross-sectional questionnaire survey. Regression results revealed that susceptibility to pertussis, seriousness of pertussis, perceived benefits of the vaccine, knowledge of risk factors of pertussis, and general health motivation together explained 76% of the variance of women's intention to receive the pertussis vaccine. Perceived benefits of the vaccine was the most significant factor affecting pregnant women's intention to receive the pertussis vaccine during pregnancy (p<0.05). Native-born women had higher intention to be vaccinated and more positive health beliefs (p<0.05).
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Affiliation(s)
- Merav Ben Natan
- Pat Matthews School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel.
| | - Bat El Kravchenko
- Pat Matthews School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
| | - Ksenya Sakashidlo
- Pat Matthews School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
| | - Shelly Mor
- Pat Matthews School of Nursing, Hillel Yaffe Medical Center, Hadera, Israel
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Butler AM, Layton JB, Li D, Hudgens MG, Boggess KA, McGrath LJ, Weber DJ, Becker-Dreps S. Predictors of Low Uptake of Prenatal Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Immunization in Privately Insured Women in the United States. Obstet Gynecol 2017; 129:629-37. [PMID: 28277354 DOI: 10.1097/AOG.0000000000001927] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To examine the uptake of prenatal tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) immunization among pregnant women in the United States. METHODS Using MarketScan data, we conducted a historical cohort study among pregnant women with employer-based commercial insurance in the United States who delivered between January 1, 2010, and December 31, 2014. We examined temporal trends of uptake, predictors of uptake, and timing of Tdap immunization. RESULTS Among 1,222,384 eligible pregnancies in 1,147,711 women, receipt of prenatal Tdap immunization increased from 0.0% of women who delivered in January 2010 to 9.8% who delivered in October 2012 (the date of the recommendation by the Advisory Committee on Immunization Practices for Tdap during every pregnancy) to 44.4% who delivered in December 2014. Among women who received Tdap during pregnancy, the majority were immunized between 27 weeks and 36 6/7 weeks of gestation per the Advisory Committee on Immunization Practices recommendation. In multivariable analyses among women who delivered between November 2012 and December 2014, rates of prenatal Tdap immunization were lower for women younger than 25 years of age (eg, 20-24 compared with 30-34 years rate ratio [RR] 0.83, 95% confidence interval [CI] 0.85-0.88), with other children (eg, three compared with zero children: RR 0.86, 95% CI 0.84-0.88), residing in the South compared with the Midwest (RR 0.81, 95% CI 0.80-0.82), or with emergency department visits in early pregnancy (RR 0.93, 95% CI 0.92-0.95). The proportion of pregnant women who received prenatal Tdap increased with increasing gestational age at birth. CONCLUSION By the end of 2014, fewer than half of pregnant women in the United States were receiving prenatal Tdap immunization. Implementation and dissemination strategies are needed to increase Tdap coverage among pregnant women, especially those who are young, have other children, or reside in the South.
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Abstract
Pertussis vaccination in pregnancy has been introduced by several national advisory bodies, mostly in industrialized countries, as a means to protect young infants from disease by high titers of maternal antibodies. Most recommendations derive from epidemiological needs, but many knowledge gaps remained after implementation. This report aims to overview the solved and unsolved aspects of prenatal vaccination with a pertussis containing vaccine.
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Maertens K, Braeckman T, Top G, Van Damme P, Leuridan E. Maternal pertussis and influenza immunization coverage and attitude of health care workers towards these recommendations in Flanders, Belgium. Vaccine 2016; 34:5785-5791. [DOI: 10.1016/j.vaccine.2016.09.055] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/19/2016] [Accepted: 09/28/2016] [Indexed: 10/20/2022]
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Visser O, Kraan J, Akkermans R, Ruiter RAC, van der Velden K, Hautvast JLA, Hulscher MEJL. Assessing determinants of the intention to accept a pertussis cocooning vaccination: A survey among Dutch parents. Vaccine 2016; 34:4744-4751. [PMID: 27523741 DOI: 10.1016/j.vaccine.2016.07.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 07/08/2016] [Accepted: 07/14/2016] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Pertussis cocooning is one of the strategies aiming to prevent the potential harm of pertussis in infants by vaccinating (among others) their parents. Several countries adopted this strategy, but uptake is a problem. Determinants of parental uptake are important in the design of an effective vaccination programme. Therefore, this study aims to assess parents' intention to accept a pertussis cocooning vaccination and its determinants. METHODS A 98 item questionnaire was developed based on a theoretical framework, assessing parents' intention to accept a pertussis cocooning vaccination and its personal and psychosocial determinants. In addition, beliefs underlying parents' attitude towards pertussis cocooning vaccination were assessed. Both logistic and linear regression analysis were used to assess univariate and multivariate associations amongst study variables. RESULTS Parents returned 282 questionnaires. The majority of the parents (78%) reported a positive intention to accept a pertussis cocooning vaccination. Attitude (OR 6.6, p<.001), anticipated negative affect in response to non acceptance (OR 1.65, p<.001), anticipated negative affect in response to acceptance (OR 0.55, p .040) and decisional uncertainty (OR 0.52, p .002) were significantly associated with intention. General vaccination beliefs (β 0.58, p<.001), moral norm (β 0.22, p<.001), perceived susceptibility of pertussis in children (β 0.10, p.004), and efficacy outcome expectations (β 0.15, p.011) were significant correlates of attitude towards pertussis cocooning vaccination. CONCLUSION The parental intention to accept a pertussis cocooning vaccination in this study is rather high. Targeting the identified determinants of parents' acceptance in a pertussis cocooning vaccination programme is crucial to secure that intention is translated into actual vaccination uptake.
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Affiliation(s)
- Olga Visser
- Department of Primary and Community Care, Radboudumc, 117 ELG, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; Municipal Health Service Utrecht Region, P.O. Box 51, 3700 AB Zeist, The Netherlands.
| | - Janneke Kraan
- Municipal Health Service Utrecht Region, P.O. Box 51, 3700 AB Zeist, The Netherlands.
| | - Reinier Akkermans
- Department of Primary and Community Care, Radboudumc, 117 ELG, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands; Scientific Institute for Quality of Healthcare, IQ Healthcare, Radboudumc, 114 IQ, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Robert A C Ruiter
- Department of Work and Social Psychology, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | - Koos van der Velden
- Department of Primary and Community Care, Radboudumc, 117 ELG, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Jeannine L A Hautvast
- Department of Primary and Community Care, Radboudumc, 117 ELG, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Marlies E J L Hulscher
- Scientific Institute for Quality of Healthcare, IQ Healthcare, Radboudumc, 114 IQ, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
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Visser O, Hautvast JLA, van der Velden K, Hulscher MEJL. Intention to Accept Pertussis Vaccination for Cocooning: A Qualitative Study of the Determinants. PLoS One 2016; 11:e0155861. [PMID: 27253386 PMCID: PMC4890858 DOI: 10.1371/journal.pone.0155861] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 05/05/2016] [Indexed: 12/21/2022] Open
Abstract
Context Several countries have reported a resurgence of pertussis in the last decades. This puts infants (especially <6 months) at risk of severe complications, because they are too young to be fully protected by vaccination. The global pertussis initiative has proposed pertussis vaccination of young infants’ close contacts, in order to reduce pertussis transmission and the burden of the disease on infants. Our aim is to explore the perceived determinants (barriers and facilitators) of intention to accept vaccination among the possible target groups of pertussis vaccination for cocooning. Consideration of these determinants is necessary to optimise the uptake of the vaccination. Methods We conducted 13 focus groups and six individual semi-structured interviews with members of possible target groups for pertussis cocooning (i.e. parents, maternity assistants, midwives, and paediatric nurses) in the Netherlands. Here, both maternal pertussis vaccination as well as pertussis cocooning has not been implemented. The topic list was based on a literature review and a barrier framework. All interviews were transcribed verbatim and two researchers performed thematic content analysis. Findings The participants’ risk perception, outcome expectations, general vaccination beliefs, moral norms, opinion of others, perceived autonomy, anticipated regret, decisional uncertainty, and perceived organisational barriers were all factors that influenced the intention to accept pertussis vaccination for cocooning. Discussion This study has identified nine perceived determinants that influence the intention to accept pertussis cocooning vaccination. We add the following determinants to the literature: perceived cost-effectiveness (as a concept of outcome expectations), justice (as a concept of moral norms), anticipated regret, and decisional uncertainty. We recommend considering these determinants in vaccination programmes for pertussis cocooning vaccination. Experience, information and trust emerged as predominant themes within these determinants. These themes require particular attention in future research on vaccination acceptance, especially with regard to their role in use and implementation in policy and practice.
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Affiliation(s)
- Olga Visser
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
- * E-mail:
| | - Jeannine L. A. Hautvast
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Koos van der Velden
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marlies E. J. L. Hulscher
- Scientific Institute for Quality of Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands
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Wilson RJ, Paterson P, Jarrett C, Larson HJ. Understanding factors influencing vaccination acceptance during pregnancy globally: A literature review. Vaccine 2015; 33:6420-9. [DOI: 10.1016/j.vaccine.2015.08.046] [Citation(s) in RCA: 198] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 08/06/2015] [Accepted: 08/11/2015] [Indexed: 01/22/2023]
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Dempsey AF, Brewer SE, Sevick C, Pyrzanowski J, Mazzoni S, O'Leary ST. Tdap vaccine attitudes and utilization among pregnant women from a high-risk population. Hum Vaccin Immunother 2015; 12:872-8. [PMID: 26430729 DOI: 10.1080/21645515.2015.1094594] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Infants infected with Bordatella pertussis experience high morbidity and significant mortality. Vaccinating pregnant mothers with the tetanus-diphtheria-acellular pertussis (Tdap) vaccine is a recommended strategy for preventing infant pertussis. This is especially important for mothers living in poverty and from racial and ethnic minority populations as these groups are at increased risk of having a pertussis-affected infant. Using the Health Belief Model as a framework, we surveyed a convenience sample of pregnant mothers representing these high-risk populations to understand factors associated with Tdap vaccine uptake during their pregnancy. Among the 316 mothers surveyed, 82% had gotten or planned to get Tdap that same day even though 63% of the sample had concerns about the safety of the vaccine during pregnancy. Perceived benefits and norms were the Health Belief Model constructs most consistently associated with Tdap vaccination. Although 32% of women reported prior Tdap vaccine receipt, this factor was not associated with Tdap vaccination during the current pregnancy, contrasting studies of vaccination done in non-pregnant populations. Important variations in attitudes were apparent, with Spanish-speaking women significantly more likely to have concerns about the vaccine's safety and efficacy than English-speaking women. This study indicates that among this high-risk population acceptance of Tdap vaccine during pregnancy is high. However, our results suggest that it may be important to modify information conveyed about the safety and importance of Tdap during pregnancy based on individual level factors such as language or acculturation.
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Affiliation(s)
- Amanda F Dempsey
- a Adult and Child Center for Outcomes Research and Delivery Science Program (ACCORDS), University of Colorado Denver , Aurora , CO , USA
| | - Sarah E Brewer
- a Adult and Child Center for Outcomes Research and Delivery Science Program (ACCORDS), University of Colorado Denver , Aurora , CO , USA
| | - Carter Sevick
- a Adult and Child Center for Outcomes Research and Delivery Science Program (ACCORDS), University of Colorado Denver , Aurora , CO , USA
| | - Jennifer Pyrzanowski
- a Adult and Child Center for Outcomes Research and Delivery Science Program (ACCORDS), University of Colorado Denver , Aurora , CO , USA
| | - Sara Mazzoni
- b Obstetrics and Gynecology, Denver Health and Hospital Authority , Denver , CO , USA
| | - Sean T O'Leary
- a Adult and Child Center for Outcomes Research and Delivery Science Program (ACCORDS), University of Colorado Denver , Aurora , CO , USA
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