Maternal vaccinations coverage and reasons for non-compliance - a cross-sectional observational study

Abstract

Background Maternal influenza and pertussis vaccinations have been proven safe and effective in reducing maternal and infant morbidity and mortality. Though recommended, not all pregnant women receive these important vaccines. We aimed to evaluate the vaccine coverage of maternal immunization in pregnancy for seasonal influenza and acellular pertussis and elucidate the reasons for non-vaccination among pregnant women. The secondary objective was to describe factors that affect vaccine uptake. Methods A cross sectional observational study using anonymous questionnaires distributed to women in the maternity ward or pregnant women hospitalized in the high-risk ward, between Nov 2017 and June 2018, In an Israeli tertiary hospital. Results Of 321 women approached, 313 were eligible, with a total of 290 women completing the questionnaire (92.6%). We found a 75.9% (95% CI 71–81) and 34.5% (95% CI 29–40) vaccination rate for pertussis and influenza vaccines, respectively. The most prominent reason for not receiving the pertussis vaccine was being under-informed (24%). Influenza vaccine was not received mainly due to concerns about vaccine efficacy (28%). Other factors influencing vaccine uptake included education, prior childbirth and vaccine recommendations made by the provider. Conclusion Although maternal vaccination of pertussis and influenza is officially recommended, vaccine uptake is suboptimal. Our study suggests a central role for medical providers in diminishing the concerns about safety and efficacy, and presents novel factors influencing compliance rates, like seasonality and number of prior births.

Vaccination information, motivations, and barriers in the context of meningococcal serogroup A conjugate vaccine introduction: A qualitative assessment among caregivers in Burkina Faso, 2018

“…Our results are consistent with data from high-income countries, showing that healthcare worker recommendations are a strong predictor of vaccination uptake [28] , [29] , [30] . In our assessment, healthcare workers were viewed as trusted sources of information and their recommendations motivated caregivers to return to the healthcare center for scheduled vaccination visits.…”

The National Immunization Technical Advisory Group in Israel

“…Adult vaccines introduced in recent years include the pertussis vaccine in the third trimester of pregnancy (2015) with an estimated 75% coverage [ 34 ]. Pertussis patterns modeling (1998–2019) before and after 2015, showed decline in pertussis incidence (71%) and hospitalizations (58%) among infants aged 2 months and younger, probably associated with maternal vaccination [ 35 ].…”

Alignment of national COVID-19 vaccine recommendations for pregnant and lactating women

“…Evidence-based decision-making processes to reach a consensus with peak medical organizations will assist in minimizing confusion and building public trust. Achieving high vaccine coverage among pregnant women is often challenging 29 and new approaches need to be considered. One such innovation is bringing together not only national immunization technical advisory groups but also experts in the population of interest: pregnant women.…”