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

David Drezner,Michal Youngster,Hodaya Klainer,Ilan Youngster

doi:10.1186/s12884-020-03243-w

David Drezner, Michal Youngster + Show 2 more

Open Access

https://doi.org/10.1186/s12884-020-03243-w

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Abstract

BackgroundMaternal 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.MethodsA 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.ResultsOf 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.ConclusionAlthough 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.

Highlights

Maternal influenza and pertussis vaccinations have been proven safe and effective in reducing maternal and infant morbidity and mortality
Seventy six percent and 34.5% of participants reported being vaccinated for pertussis and influenza respectively (Table 1)
This low maternal influenza vaccine uptake is found despite comparable recommendation rates given by primary caregivers, a factor that was found to be a strong predictor of maternal acceptance

Summary

Introduction

Maternal influenza and pertussis vaccinations have been proven safe and effective in reducing maternal and infant morbidity and mortality. 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. Bordetella Pertussis and Influenza are causes of potentially lethal, but preventable, respiratory infections in infants and pregnant women [1,2,3]. Infant vaccination programs, implemented worldwide, are extremely effective in reducing infection, morbidity and mortality for numerous pathogens. Maternal immunization for pertussis and influenza are a safe and effective way to reduce both maternal and infant morbidity and mortality [4,5,6]. As for influenza, pregnant women are more likely to experience severe complications compared with the general population [9]. Maternal vaccinations are effective in preventing maternal infection [11] and reduce infant morbidity if infected [12]

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