Abstract
The uptake of maternal influenza and pertussis vaccinations is often suboptimal. This study explores the factors influencing pregnant women’s and health care professionals’ (HCPs) behaviour regarding maternal vaccinations (MVs). Pregnant/recently pregnant women, midwives, pharmacists and general practice staff in Waikato, New Zealand, were interviewed. The analysis used the behaviour change wheel model. Interviews of 18 women and 35 HCPs revealed knowledge about MVs varied with knowledge deficiencies hindering the uptake, particularly for influenza vaccination. HCPs, especially midwives, were key in raising women’s awareness of MVs. Experience with vaccinating, hospital work (for midwives) and training increased HCPs’ knowledge and proactivity about MVs. A “woman’s choice” philosophy saw midwives typically encouraging women to seek information and make their own decision. Women’s decisions were generally based on knowledge, beliefs, HCPs’ emphasis and their perceived risk, with little apparent influence from friends, family, or online or promotional material. General practice’s concentration on children’s vaccination and minimal antenatal contact limited proactivity with MVs. Busyness and prioritisation appeared to affect HCPs’ proactivity. Multi-pronged interventions targeting HCPs and pregnant women and increasing MV access are needed. All HCPs seeing pregnant women should be well-informed about MVs, including how to identify and address women’s questions or concerns about MVs to optimise uptake.
Highlights
IntroductionPertussis and influenza vaccinations during pregnancy are recommended and funded in many countries [1,2]
The qualitative research published to date from this study has described the perspectives and experiences of women and health care professionals’ (HCPs) with respect to funded maternal vaccinations (MVs) in pharmacies [51]
We found HCPs with recent training or experience with MVs appeared to be more confident with MV discussions and more proactive about MVs
Summary
Pertussis and influenza vaccinations during pregnancy are recommended and funded in many countries [1,2]. Pertussis (whooping cough) causes hospitalisations and deaths, of young infants [3,4]. A tetanus–diphtheria–acellular–pertussis (Tdap) vaccination during pregnancy protects young infants against severe pertussis [5,6]. Increased influenza-associated mortality and hospitalisations [7] and adverse fetal outcomes are associated with influenza during pregnancy [8]. Maternal influenza vaccination is associated with a reduced risk of influenza-associated hospitalisations of pregnant women [9] and infants [10]
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