The challenges and opportunities of translating best practice immunisation strategies among low performing general practices to reduce equity gaps in childhood immunisation coverage in New Zealand

Turner, Nikki; Charania, Nadia A.; Chong, Angela; Stewart, Joanna; Taylor, Lynn

doi:10.1186/s12912-017-0226-2

Cited by 8 publications

(4 citation statements)

References 20 publications

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“…Individuals who decide not to vaccinate or were still undecided are often influenced by their perception of low likelihood of disease [ 14 , 37 ], because they do not usually get vaccinated [ 19 , 37 ], or because they do not consider it a priority [ 43 ]. Interviews with Māori women and Māori health providers about maternal vaccinations found the health providers often noting women not prioritising vaccinations [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…The fact that there is crossover from findings from studies from over a decade ago [ 36 , 37 ] indicate that further strategies are required for effective change to improve maternal vaccination rates, particularly for Māori or Pacific women who have inequitable maternal vaccination coverage. Recommendations to improve vaccination coverage have ranged from additional funded visits to GPs and nurses to discuss immunisations [ 17 ], training of health care professionals [ 50 ], funded availability through pharmacies [ 51 ], administration in the antenatal visit setting, constant vaccine reminders throughout pregnancy [ 18 , 43 ], large public health campaigns, and removal of barriers to access [ 42 ]. Ultimately, a multi-pronged method to enhance vaccination uptake is needed, with improving knowledge of vaccination in pregnancy underpinning the approach.…”

Section: Discussionmentioning

confidence: 99%

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Knowledge and decisions about maternal immunisation by pregnant women in Aotearoa New Zealand

Young

Charania

Gauld

et al. 2022

BMC Health Serv Res

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Background Maternal vaccinations for influenza and pertussis are recommended in New Zealand to protect mothers and their infant from infection. However, maternal immunisation coverage in New Zealand is suboptimal. Furthermore, there is unacceptable inequitable maternal immunisation rates across the country with Māori and Pacific women having significantly lower maternal immunisation rates than those of other New Zealanders. Methods This research set out to explore what pregnant/recently pregnant Māori and Pacific women knew about immunisation during pregnancy and what factors influenced their decision to be vaccinated. A semi-structured interview guide was developed with questions focusing on knowledge of pertussis and influenza vaccination during pregnancy and decision-making. Māori and Pacific women aged over 16 years were purposively sampled and interviewed in Dunedin and Gisborne, New Zealand between May and August 2021. Interviews were analysed following a directed qualitative content approach. Data were arranged into coding nodes based on the study aims (deductive analysis) informed by previous literature and within these participant experiences were inductively coded into themes and subthemes. Results Not all women were aware of maternal vaccine recommendations or they diseases they protected against. Many underestimated how dangerous influenza and pertussis could be and some were more concerned about potential harms of the vaccine. Furthermore, understanding potential harms of infection and protection provided by vaccination did not necessarily mean women would choose to be vaccinated. Those who decided to vaccinate felt well-informed, had vaccination recommended by their healthcare provider, and did so to protect their and their infant’s health. Those who decided against vaccination were concerned about safety of the vaccines, lacked the information they needed, were not offered the vaccine, or did not consider vaccination a priority. Conclusions There is a lack of understanding about vaccine benefits and risks of vaccine-preventable diseases which can result in the reinforcement of negative influences such as the fear of side effects. Furthermore, if vaccine benefits are not understood, inaccessibility of vaccines and the precedence of other life priorities may prevent uptake. Being well-informed and supported to make positive decisions to vaccinate in pregnancy is likely to improve vaccine coverage in Māori and Pacific Island New Zealanders.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Knowledge and decisions about maternal immunisation by pregnant women in Aotearoa New Zealand

Young

Charania

Gauld

et al. 2022

BMC Health Serv Res

Self Cite

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“…This survey concluded that health care professionals needed to be aware of differing health beliefs amongst ethnic groups to enable them to tailor their consultations to address cultural-specific vaccine concerns (Greenfield et al, 2015). Tailoring consultations to a specific ethnic group to increase immunisation uptake was found to be effective in an intervention study in New Zealand (Turner et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

How practice nurses engage with parents during their consultations about the MMR vaccine: a qualitative study

Hill

Salmon

Chudleigh

et al. 2021

Prim Health Care Res Dev

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Aim: We aimed to understand practice nurses’ perceptions about how they engage with parents during consultations concerning the measles, mumps and rubella (MMR) vaccine. Background: The incidence of measles is increasing globally. Immunisation is recognised as the most significant intervention to influence global health in modern times, although many factors are known to adversely affect immunisation uptake. Practice nurses are a key member of the primary care team responsible for delivering immunisation. However, little is known how practice nurses perceive this role. Methods: Semi-structured interviews were undertaken with 15 practice nurses in England using a qualitative descriptive approach. Diversity in terms of years of experience and range of geographical practice settings were sought. These interviews were recorded, transcribed verbatim and open-coded using qualitative content analysis to manage, analyse and identify themes. Findings: Three themes were derived from the data: engaging with parents, the informed practice nurse and dealing with parental concerns: strategies to promote MMR uptake. During their consultations, practice nurses encountered parents who held strong opinions about the MMR vaccine and perceived this to be related to the parents’ socio-demographic background. Practice nurses sought to provide parents with tailored and accurate sources of information to apprise their immunisation decision-making about the MMR vaccine.

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“…A universal set of messages will not by itself improve adult immunization rates and recent studies highlight the critical need for various tools and strategies commensurate with the characteristics of the populations [19]. Incorporating a framework that considers these determinants in vaccine policy design and implementation will foster immunization equity among the most at-risk populations against seasonal influenza and other respiratory vaccine-preventable diseases [20].…”

Section: Social Determinants and Immunizationmentioning

confidence: 99%

Towards Ending Immunization Inequity

Sangster

Barratt

2021

Vaccines

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Vaccine-preventable diseases (VPD) are responsible for a significant portion of mortality across the life course in both low-income countries and in medium- and high-income countries. Yet, countries are consistently below the adult influenza vaccination targets, with rates in recent times even falling in some areas. (1) The study Towards Ending Immunization Inequity seeks to understand the various factors that contribute to the accessibility and effectiveness of vaccine-related messages and campaigns including the effects of social determinants, with the knowledge that these opportunities for communication represent a unique policy lever to improving uptake rates of vaccination in the most at-risk communities. (2) To address this knowledge gap, a 3-phase mixed-methods study was conducted including a preliminary scan of existing vaccine schedules and NITAG recommendations, focus groups and a cross-sectional survey. (3) Study results indicated that social determinants play a key role in an individual’s knowledge of vaccine-related information including types of vaccines available, vaccination gateways, vaccine recommendations and vaccine safety. (4) However, knowing that social determinants can influence uptake rates does not readily create opportunities and entry points for governments to implement tangible actions. An accessible entry point to reducing and ending immunization inequity is through changes in public health messaging to reach those who are currently unreachable.

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The challenges and opportunities of translating best practice immunisation strategies among low performing general practices to reduce equity gaps in childhood immunisation coverage in New Zealand

Cited by 8 publications

References 20 publications

Knowledge and decisions about maternal immunisation by pregnant women in Aotearoa New Zealand

Knowledge and decisions about maternal immunisation by pregnant women in Aotearoa New Zealand

How practice nurses engage with parents during their consultations about the MMR vaccine: a qualitative study

Towards Ending Immunization Inequity

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