Vaccination in pregnancy: The role of the midwife

Homer, Caroline; Javid, Nasrin; Wilton, Kellie; Bradfield, Zoe

doi:10.3389/fgwh.2022.929173

Cited by 4 publications

(6 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Service users and providers in our study and elsewhere felt there was insufficient (long-term) research on Covid-19 vaccinations in pregnancy [ 78 ], in keeping with recent calls for inclusion of pregnant women in clinical trials [ 79 ]. This also supports calls for better pre-service training and continuous education for HCP with updated information on new vaccines and opportunities for open and honest dialogue [ 77 , 80 ]. HCP should also be able to advise on what exactly vaccines contain.…”

Section: Discussionmentioning

confidence: 59%

“Figuring stuff out myself” – a qualitative study on maternal vaccination in socially and ethnically diverse areas in England

et al. 2023

View full text Add to dashboard Cite

Background Maternal vaccinations against Influenza, Pertussis, and Covid-19 are recommended in the UK, and vaccines against further infections may become available soon. However, many pregnant women, especially in socially and ethnically diverse areas, have low vaccine uptake. Qualitative studies on the reasons and possible solutions are needed that are inclusive of disadvantaged and minority ethnic groups. We therefore aimed to understand the complex interplay between structural and behavioural factors contributing to the low maternal vaccine uptake in socially and ethnically diverse areas in London in the Covid-19 context. Methods In 2022, we conducted semi-structured interviews and a focus group discussion among a purposive sample of 38 pregnant/recently pregnant women and 20 health service providers, including 12 midwives. Participants were recruited in ethnically diverse London boroughs. We followed a critical realist paradigm and used a thematic analysis approach. Results The sample included participants who took all, some or none of the maternal vaccines, with some participants unsure whether they had taken or been offered the vaccines. Decision-making was passive or active, with the expectation for pregnant women to do their 'own research'. Participants described various individual, social and contextual influences on their decision-making as they navigated the antenatal care system. Missing or conflicting information from providers meant knowledge gaps were sometimes filled with misinformation from unreliable sources that increased uncertainties and mistrust. Both pregnant women and providers described structural and organisational factors that hindered access to information and vaccinations, including lack of training, time and resources, and shortcomings of health information systems and apps. Some participants described factors that facilitated vaccination uptake and many made recommendations for improvements. Conclusions Our study showed how structural and organisational factors can compound uncertainties around maternal vaccination among socially and ethnically diverse populations. Results highlight the need for more reliable resources, streamlined workflows, improved electronic information systems and training in their use. Roles and responsibilities should be clarified with potential greater involvement of nurses and pharmacists in vaccine provision. Education and communication should consider individual (language/digital) skills and needs for information and reassurance. Further research is needed to co-produce solutions with service users and providers.

show abstract

Section: Discussionmentioning

confidence: 59%

“Figuring stuff out myself” – a qualitative study on maternal vaccination in socially and ethnically diverse areas in England

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Several strategies put in place before the survey most likely contributed to the high vaccine uptake in our study (Data S1). These included the national and state campaigns promoting COVID‐19 vaccination, strong leadership from ACM 13 and RANZCOG as the leading healthcare organizations in the country for women's health, and an effective integrated response of our health district. This study confirms that receiving information and recommendation from clinicians, who have knowledge and confidence in discussing vaccination with pregnant women, is associated with increased vaccination uptake 20–24 .…”

Section: Discussionmentioning

confidence: 99%

“…In a swift response to an unprecedented pandemic, RANZCOG and the Australian College of Midwives (ACM) developed online resources for the clinicians and community on their website regarding the safety of the vaccine in pregnancy. 12,13 In addition, an integrated response was designed in our local health district in NSW to address some of the known barriers 14 to vaccination (Data S1). For example, Midwives and obstetricians were encouraged to provide vaccine information to pregnant women during routine antenatal visits and recommend vaccination to women who had not received COVID-19 vaccine previously.…”

Section: Introductionmentioning

confidence: 99%

“…It is unknown whether such fear or anxiety increased and impacted on women's decision to be vaccinated. In a swift response to an unprecedented pandemic, RANZCOG and the Australian College of Midwives (ACM) developed online resources for the clinicians and community on their website regarding the safety of the vaccine in pregnancy 12,13 …”

Section: Introductionmentioning

confidence: 99%

“…Midwives were invited to attend a live 1‐h educational session to improve their knowledge on the current evidence regarding the impact of COVID‐19 on maternal and perinatal outcomes, the safety of vaccination during pregnancy, and communication skills regarding vaccine recommendation. To improve vaccine counseling confidence, midwives were provided with ACM resources, such as talking sheets, infographics, and tools, 13 and encouraged to use them during routine antenatal visits to facilitate vaccine uptake among pregnant women.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Factors influencing uptake of the COVID‐19 vaccination among pregnant women in Australia: A cross‐sectional survey

Javid

Phipps

Homer

et al. 2023

Birth

Self Cite

View full text Add to dashboard Cite

BackgroundMounting evidence shows the risk of COVID‐19 on perinatal outcomes, as well as the safety and efficacy of vaccination during pregnancy. However, little is known about vaccine uptake among pregnant women in Australia, including women who are culturally and linguistically diverse (CALD), and about sources of information pregnant women use when making decisions about vaccines. We aimed to determine the proportion of pregnant women who had been vaccinated and to identify factors associated with vaccine uptake or decline during pregnancy.MethodA cross‐sectional, anonymous, online survey was conducted from October 2021 to January 2022 in two metropolitan hospitals in New South Wales, Australia.ResultsOf 914 pregnant women, 406 (44%) did not speak English at home. Overall, 101 (11%) received a vaccine prepregnancy and 699 (76%) during pregnancy. In the nonvaccinated cohort, 87 (76%) declined vaccination during pregnancy. The uptake was more than 87% among women during pregnancy who received information from government or health professional websites but 37% when received from personal blogs. The main reasons for vaccine uptake were (1) hearing that COVID‐19 affects pregnant women, (2) being concerned about the COVID‐19 outbreak, and (3) receiving vaccine recommendation from a general practitioner. In a multivariable logistic regression, three main factors associated with declining or feeling unsure about vaccination were (1) concerns about the safety of the COVID‐19 vaccine, (2) lack of trust and being unsatisfied with the information received about COVID‐19 vaccination during pregnancy, and (3) doubting the importance of COVID‐19 vaccine.ConclusionClinicians play a critical role in counseling women to alleviate vaccine fear, support vaccine acceptance, and direct women to use reliable information sources, such as government and professional healthcare organizations, for information about vaccines.

show abstract

Immunization during pregnancy: do healthcare workers recommend vaccination against influenza?

Licata,

Pelullo,

Della Polla

et al. 2023

Front. Public Health

View full text Add to dashboard Cite

BackgroundA variety of circumstances can influence how widely vaccination during pregnancy is accepted. Healthcare workers (HCWs) are often seen as the main resource for recommending vaccination. The purpose of the current study was to determine whether Italian HCWs advise and recommend pregnant people to receive the influenza vaccinations, as well as what knowledge and attitudes affect their practices. A secondary aim of the study was to evaluate HCWs’ knowledge and attitudes towards COVID-19 vaccination.MethodsThis cross-sectional study, took place between August 2021 and June 2022 in a randomly selected sample of HCWs in three Italian regions. The target population comprised obstetricians-gynecologists, midwives and primary care physicians, who provide medical care to pregnant people. The questionnaire consisted of 19 items divided into 5 parts gathered information about the participants’ sociodemographic and professional characteristics, general knowledge about vaccinations during pregnancy, and vaccine-preventable diseases (VPDs), attitudes and practices towards immunization, and strategies to potentially increase vaccination uptake during pregnancy.ResultsAmong the participants, 78.3% knew that pregnant people are at increased risk of severe complications from influenza, 57.8% that the influenza vaccine is not provided only in the 2nd/3rd trimester of pregnancy and 60% that pregnancy is a risk factor for severe COVID-19 infection. Of the enrolled HCWs, 10.8% believed that the potential risks of vaccines administered during pregnancy are greater than the benefits. An even higher proportion of the participants was unsure (24.3%) or did not deem (15.9%) that vaccinating against influenza during pregnancy reduces the risk of preterm birth and abortion. Moreover, 11.8% of the sample did not believe or was uncertain that COVID-19 vaccine must be offered to all pregnant people. Among HCWs, 71.8% advised women about influenza vaccination during pregnancy, and 68.8% recommended getting vaccinated against influenza during pregnancy. Results showed that good knowledge and positive attitudes were the strongest factors positively associated with advising women about influenza vaccination during pregnancy.ConclusionThe gathered data showed that a sizable portion of the HCWs lacks up-to-date knowledge, underestimates the risks of contracting a VPD, and overestimates the risks of vaccine side effects during pregnancy. The findings shed light on such attributes useful to promote adherence to evidence-based recommendations among HCWs.

show abstract

Vaccination in pregnancy: The role of the midwife

Cited by 4 publications

References 43 publications

“Figuring stuff out myself” – a qualitative study on maternal vaccination in socially and ethnically diverse areas in England

“Figuring stuff out myself” – a qualitative study on maternal vaccination in socially and ethnically diverse areas in England

Factors influencing uptake of the COVID‐19 vaccination among pregnant women in Australia: A cross‐sectional survey

Immunization during pregnancy: do healthcare workers recommend vaccination against influenza?

Contact Info

Product

Resources

About