What determines uptake of pertussis vaccine in pregnancy? A cross sectional survey in an ethnically diverse population of pregnant women in London

Adult AWARENESS Health Knowledge, Attitudes, Practice Adolescent Immunology ENGLAND UNITED-STATES Research & Experimental Medicine SELF-REPORT Pertussis vaccine 618 WALES Young Adult 03 medical and health sciences 0302 clinical medicine Pregnancy Virology 616 ADOLESCENTS London Ethnicity Humans Pertussis Vaccine Science & Technology Influenza vaccine Research & Experimental Acceptancy ADULTS 11 Medical And Health Sciences 06 Biological Sciences Patient Acceptance of Health Care CARE PROVIDERS INTENTION 3. Good health Cross-Sectional Studies Medicine, Research & Experimental Attitudes Medicine Female 07 Agricultural And Veterinary Sciences Pregnant Women INFLUENZA VACCINATION Life Sciences & Biomedicine
DOI: 10.1016/j.vaccine.2015.08.093 Publication Date: 2015-09-26T02:21:18Z
ABSTRACT
Following the major outbreak of pertussis and 14 infant deaths across England in 2012, the Department of Health (DH) introduced the UK's first maternal pertussis vaccination programme. Data published by Public Health England (PHE) suggest uptake of the vaccine varies considerably across the country. The reasons for this heterogeneity need to be addressed to optimise the impact of the programme.To assess uptake of antenatal pertussis and influenza vaccine in a leading NHS Trust in London and to explore awareness and attitudes of pregnant women towards the pertussis vaccination programme.A cross sectional survey was conducted in an ethnically diverse group of 200 pregnant women accessing antenatal care at Imperial Healthcare NHS Trust. Quantitative data was tabulated and content analysis was carried out on the free text. Qualitative data was divided into themes for accepting or declining the vaccine.Awareness of the programme was 63% (126/200) with actual uptake of the vaccine only 26.0% (52/200). Women had received information from multiple sources, primarily General Practitioners (GP) and midwives. 34.0% (68/200) of women were offered the vaccine at their GP practice, only 24% reported a meaningful discussion with their GP about it. Uptake differed by up to 15.0% between ethnicities. Qualitative data showed that uptake could be significantly enhanced if vaccination was recommended by a familiar healthcare professional. Feeling uninformed, lack of professional encouragement and uncertainties of risk and benefit of the vaccine were the greatest barriers to uptake.Vaccine uptake in this cohort of pregnant women was poor. Understanding the target audience and engaging with key groups who influence women's decision-making is essential. Knowledgeable health care professionals need to recommend the vaccine and provide accurate and timely information to increase success of this important programme.
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