Factors influencing women’s decisions about having the pertussis-containing vaccine during pregnancy

Abstract

INTRODUCTION New Zealand experienced a major epidemic of pertussis from September 2011 to January 2014. In response to this epidemic, a pertussis-containing tetanus, diphtheria and acellular pertussis (Tdap) vaccine was funded for pregnant women of 28-38 weeks' gestation. AIM To investigate the factors influencing women's decisions regarding having the Tdap vaccine during pregnancy. METHODS A retrospective, self-reported postal survey of early postpartum women in Canterbury that assessed participant knowledge, beliefs, attitudes and influencing factors about the Tdap vaccine was conducted from June to October 2013. RESULTS Of the 1883 surveys distributed, 596 women completed the survey. The main factors influencing women's decisions to accept the Tdap vaccine during pregnancy were: the desire to protect their baby, a health professional's recommendation, the threat of pertussis in the community and the fact that the vaccine was administered at no cost. Conversely, for women who did not receive the Tdap vaccine, the main factors that influenced their decisions were: they did not know the vaccine was available, fear of side-effects and doubt regarding vaccine effectiveness. CONCLUSION A clear health professional recommendation for maternal Tdap immunisation was a significant factor influencing pregnant women and would most likely improve the uptake of the vaccine.

Drivers and barriers of vaccine acceptance among pregnant women in Kenya

“…Studies in Nigeria 31 and Ethiopia 32 reported that women who had received TT during pregnancy most commonly cited protection against tetanus as the reason for vaccination. Recommendation by a health-care provider has very consistently been shown to impact pregnant women's decision to be vaccinated 4,[33][34][35][36][37] although data from other African settings are limited. Nearly 60% of women in this study had received a recommendation for vaccination in their current pregnancy, and health-care providers were the most frequent source of vaccine recommendation.…”

Pertussis (whooping cough)

“…Qualitative studies among pregnant women point to a need for healthcare professionals to discuss vaccination and offer it as part of routine antenatal care 80818283…”

A Qualitative Study of Views and Experiences of Women and Health Care Professionals about Free Maternal Vaccinations Administered at Community Pharmacies

“…Uptake of pertussis vaccine during pregnancy has been low in NZ [22], approximately 38% nationally in 2017 (personal communication, Helen Petousis-Harris, 7 February 2020). The most common reason for non-uptake has been lack of awareness in women, with concerns about safety, discouragement by health care professionals and doubt about effectiveness also contributing [20,21]. NZ has universal health care funded from general taxation, providing funding for public hospitals, general practice, maternity care, and pharmaceuticals.…”

“…Therefore, maternal vaccinations during pregnancy are recommended in many developed countries [17][18][19]. Health care professional recommendation and/or endorsement of safety encourages uptake of vaccination during pregnancy [20][21][22][23][24][25]. For example, health care professional electronic record automated alerts and the provision of maternal vaccinations by midwives at antenatal appointments significantly increase uptake of a pregnancy dose of acellular pertussis vaccine [26].…”