Uptake of maternal vaccinations by Indigenous women in Central Australia

Krishnaswamy, Sushena; Thalpawila, Shamendri; Halliday, Megan; Wallace, Euan M.; Buttery, Jim; Giles, Michelle

doi:10.1111/1753-6405.12772

Cited by 4 publications

(5 citation statements)

References 3 publications

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“…This is in contrast to the non‐pregnant participants, the majority of whom reported being worried about influenza as the main reason. This finding is consistent with the literature around maternal influenza vaccination: that the lack of healthcare worker recommendations is frequently identified as the main barrier for pregnant women to receive vaccines in pregnancy 12,16 . Similarly, recommendation by healthcare provider is often the most important determinant of vaccine uptake among pregnant women 12,17,18 .…”

Section: Discussionsupporting

confidence: 90%

“…This finding is consistent with the literature around maternal influenza vaccination: that the lack of healthcare worker recommendations is frequently identified as the main barrier for pregnant women to receive vaccines in pregnancy. 12,16 Similarly, recommendation by healthcare provider is often the most important determinant of vaccine uptake among pregnant women. 12,17,18 This finding reinforces the importance of ongoing involvement of healthcare workers in promoting influenza vaccination among pregnant women.…”

Section: Discussionmentioning

confidence: 99%

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Factors influencing the uptake of influenza vaccine vary among different groups in the hard‐to‐reach population

Kong

Chu

Giles³

2020

Australian and New Zealand Journal of Public Health

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Objective: This report describes a mobile outreach influenza immunisation program for vulnerable populations in a resource‐rich setting. It explores vaccine recipients’ demographics, comorbidities and vaccination histories, and the factors influencing their decision to receive vaccine during outreach. Methods: Teams of nurse immunisers visited and provided influenza vaccines to clients from 21 sites (18 community centres for migrants, refugees and the homeless; and three outpatient clinics). Risk factors for severe influenza, vaccination histories and perceived barriers and facilitators to vaccines were collected from vaccine recipients. Results: A total of 1,032 vaccine recipients participated in the survey with responses collected from April to October 2018. Of these, 54% reported at least one risk factor for severe influenza. Sixty per cent of recipients had not received an influenza vaccine in 2017, with most of them reporting ‘not worried about influenza’ as a reason. Pregnant participants most frequently reported a healthcare provider’s recommendation as the reason to receive the vaccine. Conclusion: An outreach program comprising of a means of taking vaccines to the population was a successful strategy to deliver influenza vaccines to high‐risk populations. It needs to be considered in the full range of delivery models to improve influenza vaccine coverage, even in resource‐rich settings. Implication for public health: Strategies reaching out to vulnerable populations are crucial to maximise vaccine uptake.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Factors influencing the uptake of influenza vaccine vary among different groups in the hard‐to‐reach population

Kong

Chu

Giles³

2020

Australian and New Zealand Journal of Public Health

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“…Other studies have also found HCPs strongly influenced MV uptake in Indigenous women, [23][24][25] although our finding that pharmacists helped with this was new. Protection of the baby has arisen as an enabler of MV in similar research, 23 and could be better used to aid MV prioritisation.…”

Section: Discussioncontrasting

confidence: 53%

Mapping the maternal vaccination journey and influencing factors for Māori women in Aotearoa New Zealand: a qualitative study

Gauld

Martin²,

Sinclair

et al. 2022

J. Prim. Health Care

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Introduction. Uptake of maternal vaccinations (MVs) is suboptimal in Aotearoa New Zealand, particularly for Māori. Aim. To describe Māori women's journeys regarding maternal pertussis and influenza vaccinations and explore influences on uptake. Methods. Semi-structured interviews were conducted in Waikato, Aotearoa New Zealand, with pregnant or recently pregnant Māori women, and separately with Māori healthcare professionals (HCPs) to understand women's decisions regarding MVs and enablers and barriers to uptake. Results. Nine women and nine HCPs were interviewed. Verbal communications from midwives, general practice and pharmacy strongly influenced women's journeys. Women's decisions appeared largely straight-forward, with influences including awareness, knowledge, underlying beliefs and previous MVs. Enablers for MV uptake included HCPs' discussions, pro-vaccination beliefs, and accessibility. Barriers for MV uptake included poverty (and transport), lack of awareness, insufficient knowledge of benefits, late presentation to the midwife and other commitments or challenges in the women's lives affecting prioritisation of the vaccine. Misconceptions, seasonality, and lower HCP emphasis impaired influenza vaccination uptake. Discussion. With multiple barriers to accessing MVs, HCPs who see pregnant women are the primary resource to improve awareness, knowledge, and access through kōrero (discussions) with the woman and, where possible, being able to administer the vaccinations. These HCPs need to be well-informed, aware of likely concerns women may have and how to address them, encourage these discussions and preferably be trusted.

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“…As such, First Nations women are a priority for antenatal vaccination. Several Australian studies incorporating First Nations women have suggested the coverage of IIV in pregnancy is low (range < 3–49%), however small samples sizes and biases [ 10 – 13 ] precluded reliable estimates of coverage. We previously reported lower and declining proportions of IIV and dTpa vaccination coverage among First Nations pregnant women compared to non-Indigenous pregnant women [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Inequity of antenatal influenza and pertussis vaccine coverage in Australia: the Links2HealthierBubs record linkage cohort study, 2012–2017

McHugh

Regan

Sarna

et al. 2023

BMC Pregnancy Childbirth

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Background Pregnancy and early infancy are increased risk periods for severe adverse effects of respiratory infections. Aboriginal and/or Torres Strait Islander (respectfully referred to as First Nations) women and children in Australia bear a disproportionately higher burden of respiratory diseases compared to non-Indigenous women and infants. Influenza vaccines and whooping cough (pertussis) vaccines are recommended and free in every Australian pregnancy to combat these infections. We aimed to assess the equity of influenza and/or pertussis vaccination in pregnancy for three priority groups in Australia: First Nations women; women from culturally and linguistically diverse (CALD) backgrounds; and women living in remote areas or socio-economic disadvantage. Methods We conducted individual record linkage of Perinatal Data Collections with immunisation registers/databases between 2012 and 2017. Analysis included generalised linear mixed model, log-binomial regression with a random intercept for the unique maternal identifier to account for clustering, presented as prevalence ratios (PR) and 95% compatibility intervals (95%CI). Results There were 445,590 individual women in the final cohort. Compared with other Australian women (n = 322,848), First Nations women (n = 29,181) were less likely to have received both recommended antenatal vaccines (PR 0.69, 95% CI 0.67–0.71) whereas women from CALD backgrounds (n = 93,561) were more likely to have (PR 1.16, 95% CI 1.10–1.13). Women living in remote areas were less likely to have received both vaccines (PR 0.75, 95% CI 0.72–0.78), and women living in the highest areas of advantage were more likely to have received both vaccines (PR 1.44, 95% CI 1.40–1.48). Conclusions Compared to other groups, First Nations Australian families, those living in remote areas and/or families from lower socio-economic backgrounds did not receive recommended vaccinations during pregnancy that are the benchmark of equitable healthcare. Addressing these barriers must remain a core priority for Australian health care systems and vaccine providers. An extension of this cohort is necessary to reassess these study findings.

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Uptake of maternal vaccinations by Indigenous women in Central Australia

Cited by 4 publications

References 3 publications

Factors influencing the uptake of influenza vaccine vary among different groups in the hard‐to‐reach population

Factors influencing the uptake of influenza vaccine vary among different groups in the hard‐to‐reach population

Mapping the maternal vaccination journey and influencing factors for Māori women in Aotearoa New Zealand: a qualitative study

Inequity of antenatal influenza and pertussis vaccine coverage in Australia: the Links2HealthierBubs record linkage cohort study, 2012–2017

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