Antenatal care provider's advice is the key determinant of influenza vaccination uptake in pregnant women

Mak, Donna B; Regan, Annette K.; Joyce, Sarah; Gibbs, R.A.; Effler, Paul V.

doi:10.1111/ajo.12292

Cited by 64 publications

(68 citation statements)

References 26 publications

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“…More than 90% of the vaccinated women in our survey 239 reported being immunised to protect their baby. These results are consistent with those from 240 other national and international research efforts [8,11,13] indicating this is an important 241 message to convey to pregnant women when discussing immunisation. Unvaccinated women 242 commonly cited concerns about the safety of the vaccine as a reason for remaining 243…”

supporting

confidence: 80%

Trends in seasonal influenza vaccine uptake during pregnancy in Western Australia: Implications for midwives

et al. 2016

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supporting

confidence: 80%

Trends in seasonal influenza vaccine uptake during pregnancy in Western Australia: Implications for midwives

et al. 2016

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“…28,29,[34][35][36][37][38][39][40][41] Most women identified safety concerns such as side effects as the greatest barrier to immunization during pregnancy. [29][30][31][32][35][36][37][38]42,43,45,46 While women were concerned about their own safety 25,30,34,37,[44][45][46]51,52 or prior adverse events with the vaccine, 46,47 safety concerns for the fetus and newborn were paramount. 22,25,30,31,34,39,[44][45][46]51,52 Doubt about the effectiveness of the vaccine was particularly noted with influenza vaccine.…”

Section: Factors Related To Pregnant Womenmentioning

confidence: 99%

Improving rates of maternal immunization: Challenges and opportunities

MacDougall

Halperin

2015

Human Vaccines & Immunotherapeutics

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Objectives: An increasing number of vaccines are recommended or are being developed for use during pregnancy to protect women, fetuses, and/or newborns. For vaccines that are already recommended, vaccine uptake is variable and well below desired target. We reviewed the literature related to factors that affect a healthcare provider's recommendation and a woman's willingness to be vaccinated during pregnancy. Design: A scoping review of published literature from 2005 to 2015 was undertaken and all relevant articles were abstracted, summarized, and organized thematically. Results: Barriers and facilitators were identified that either decreased or increased the likelihood of a healthcare provider offering and a pregnant woman accepting vaccination during pregnancy. Concern about the safety of vaccines given during pregnancy was the most often cited barrier among both the public and healthcare providers. Other barriers included doubt about the effectiveness of the vaccine, lack of knowledge about the burden of disease, and not feeling oneself to be at risk of the infection. Major facilitators for maternal immunization included specific safety information about the vaccine in pregnant women, strong national recommendations, and healthcare providers who both recommended and provided the vaccine to their patients. Systems barriers such as inadequate facilities and staffing, vaccine purchase and storage, and reimbursement for vaccination were also cited. Evidence-based interventions were few, and included text messaging reminders, chart reminders, and standing orders. Conclusions: In order to have an effective vaccination program, improvements in the uptake of recommended vaccines during pregnancy are needed. A maternal immunization platform is required that normalizes vaccination practice among obstetrical care providers and is supported by basic and continuing education, communication strategy, and a broad range of research.

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“…Healthcare providers play a critical role in promoting maternal vaccination. 3 Women commonly cite concerns about the safety of vaccination to the fetus when refusing vaccination during pregnancy; results from studies evaluating adverse pregnancy outcomes should reassure pregnant patients that maternal vaccination is safe to the fetus. Healthcare providers may find results from studies measuring the reactogenicity of vaccination during pregnancy useful when communicating to pregnant women what to expect following vaccination.…”

Section: Discussionmentioning

confidence: 99%

“…This information undoubtedly contradicts the strong recommendation made by national and international health bodies and contributes to confusion among providers. Given that a provider recommendation is the strongest predictor of maternal vaccination 3 and concerns about vaccine safety are a common barrier among pregnant women, 4 well-designed safety monitoring with timely communication of results to providers and their pregnant patients is necessary for supporting antenatal and perinatal health.…”

Section: 2mentioning

confidence: 99%

The safety of maternal immunization

Regan

2016

Human Vaccines & Immunotherapeutics

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Maternal vaccination offers the opportunity to protect pregnant women and their infants against potentially serious disease. As both pregnant women and their newborns are vulnerable to severe illness, the potential public health impact of mass maternal vaccination programs is remarkable. Several highincome countries recommend seasonal influenza and acellular pertussis vaccines, and many developing countries recommend immunization against tetanus during pregnancy. There is a significant amount of literature supporting the safety of vaccination during pregnancy. As other vaccines are newly introduced for pregnant women, routine systems for monitoring vaccine safety in pregnant women are needed. To facilitate meta-analyses and comparison across systems and studies, future research and surveillance initiatives should utilize the same criteria for defining adverse events following immunization among pregnant women. At least 2 areas require further exploration: 1) identification of pregnancy outcomes associated with concomitant and closely spaced vaccines; 2) evaluation of possible improvement in birth outcomes associated with maternal vaccination. Given the public health impact of maternal vaccination, the existing evidence supporting the safety of vaccination during pregnancy should be used to reassure pregnant women and their providers and improve vaccine uptake in pregnancy.

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Antenatal care provider's advice is the key determinant of influenza vaccination uptake in pregnant women

Abstract: To optimise maternal and infant health outcomes, Australian antenatal care providers and services need to incorporate both the recommendation and delivery of influenza vaccination into routine antenatal care.

Cited by 64 publications

References 26 publications

Trends in seasonal influenza vaccine uptake during pregnancy in Western Australia: Implications for midwives

Trends in seasonal influenza vaccine uptake during pregnancy in Western Australia: Implications for midwives

Improving rates of maternal immunization: Challenges and opportunities

The safety of maternal immunization

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