Australian caregivers’ perceptions of influenza vaccination in pregnancy: A mixed methods exploration

King, Catherine; Chow, Maria Yui Kwan; Leask, Julie; Wiley, Kerrie

doi:10.1016/j.wombi.2018.07.010

Cited by 5 publications

(3 citation statements)

References 23 publications

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“…Midwives in both hospitals perceived mothers to be more hesitant about influenza vaccine than pertussis. This perception is supported by data from the state of New South Wales 13,28 and a recent Federal Government report, 29 which indicate that despite generally rising coverage rates, women still have safety concerns about the influenza vaccine during pregnancy.…”

Section: Discussionmentioning

confidence: 94%

Vaccine discussions in pregnancy: interviews with midwives to inform design of an intervention to promote uptake of maternal and childhood vaccines

Kaufman

Attwell

Hauck

et al. 2019

Human Vaccines & Immunotherapeutics

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Presumptive and Motivational Interviewing communication styles have successfully promoted childhood and adolescent vaccination to parents, but less is known about effective communication approaches during pregnancy to promote maternal vaccination and childhood vaccines. In Australian public antenatal settings, midwives provide a substantial proportion of care and are highly accessed and trusted sources of vaccine information for expectant parents. However, there are no evidence-based interventions incorporating communication strategies and resources for midwives to optimize discussions and promote acceptance of maternal and childhood vaccines. This study aimed to gather qualitative data from midwives to inform the design of a feasible and acceptable vaccine communication intervention package building on an evidence-based model utilized with US obstetricians. We explored midwives' attitudes and values regarding maternal and childhood vaccination, their perceived role in vaccine advocacy and delivery, and barriers and enablers to implementation of a potential communication intervention. We recruited 12 midwives for semi-structured interviews at two Australian tertiary public hospitals (one with antenatal vaccines onsite, one without). Interviews were analyzed using thematic template analysis. Midwives supported vaccination but expressed varied views regarding its centrality to their role. Most reported receiving minimal or no training on vaccine communication. Their communication practices focused primarily on vaccine information provision rather than persuasion, although some midwives shared personal views and actively encouraged vaccination. More vaccine and communication training and resources were requested. Findings highlight the need for communication tools that align with midwifery standards for practice to support midwives to address parents' questions and concerns about maternal and childhood vaccines.

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Section: Discussionmentioning

confidence: 94%

Vaccine discussions in pregnancy: interviews with midwives to inform design of an intervention to promote uptake of maternal and childhood vaccines

Kaufman

Attwell

Hauck

et al. 2019

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

show abstract

“…Concerns about vaccine safety were expressed by health care providers and patients. In a qualitative study in Australia, women described being actively discouraged to receive the vaccine by their doctors (King et al, 2019 ). There were, however, some additional themes unique to pandemic H1N1 vaccines that emerged in five qualitative studies with pregnant women (Cassady et al, 2012 ; Davis et al, 2015 ; Lohiniva et al, 2014 ; Lynch et al, 2012 ; Sim et al, 2011 ).…”

Section: Resultsmentioning

confidence: 99%

Understanding Barriers and Facilitators to Maternal Immunization: A Systematic Narrative Synthesis of the Published Literature

Geoghegan

Shuster

Butler

et al. 2022

Matern Child Health J

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Introduction Vaccines are being developed against Group B Streptococcus and respiratory syncytial virus. These vaccines are designed to be given to pregnant women to protect infants; thus, their success depends on uptake in this population. Maternal immunization programs have struggled to achieve target coverage rates. This systematic narrative synthesis aims to define the most important barriers and facilitators for maternal immunization and to identify priority areas for future research. Methods A search strategy was developed in Medline and adapted according to the requirements of additional search engines. Two reviewers independently reviewed the studies, using pre-specified inclusion and exclusion criteria. Results sections of included studies were coded, and thematic analysis was used to identify prominent themes. Results 321 studies were included in the final review. Most studies came from North America (37%), Europe (26%) or East Asia, Australia and New Zealand (22%). Low-and middle-income countries were under-represented. Five percent of studies came from Sub-Saharan Africa, and 2% came from South Asia. The prominent factors impacting maternal immunization were provider recommendation, perceived risks and benefits of maternal vaccines for the infant, race, birthplace, and access to healthcare. Few studies explored reasons behind racial and socioeconomic disparities in maternal immunization rates. Discussion A strong provider recommendation, equitable access to prenatal care and messaging that focuses on vaccine safety and infant benefits emerged as the key components for optimising vaccine uptake among pregnant women. Research among healthcare providers, minority groups and in low- and-middle-income countries was lacking. In anticipation of the expansion of maternal immunization programmes, focused research is needed to address these gaps and inform a successful public health strategy. Supplementary Information The online version contains supplementary material available at 10.1007/s10995-022-03508-0.

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“…A more recent South Australian study revealed that immunisation rates were able to be raised to 76% by utilising a midwifery led immunisation programme in one hospital [18]. This poor uptake of the inactivated influenza vaccine is thought to be caused by several factors ranging from: low knowledge and the need for further education amongst health professionals; and women's lack of knowledge in this area [16,17,19]. In Australia several on-line courses are available to both RN and RM on immunisation knowledge and provision and these courses are a way of closing the knowledge gap which exists for some and provides a basis for immunisation accreditation in some states [20,21].…”

Section: Introductionmentioning

confidence: 99%

An exploration of midwives’ role in the promotion and provision of antenatal influenza immunisation: A mixed methods inquiry

2021

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Problem: No South Australian study has previously investigated the role of midwives in the promotion and provision of antenatal influenza immunisation. Background: Influenza acquired in pregnancy can have serious sequalae for both mother and foetus. Recent studies have demonstrated that influenza vaccine in pregnancy is both safe and effective. Despite this, evidence suggests that vaccine uptake in pregnancy is suboptimal in both Australia and worldwide. Aim: The aim of this study was to investigate the role of midwives in the promotion and provision of antenatal influenza vaccine and, to provide a statistical and thematic description of the barriers and enablers midwives encounter. Methods: This mixed method study incorporated a cross sectional on-line survey and in-depth interviews conducted with midwives, employed in urban and regional South Australia. Findings: Quantitative data were available for 137 midwives and 10 midwives participated in the interviews. Recruitment for the interview phase was through the last question on the survey. Whilst all midwives indicated that education and vaccine promotion were part of their role, immunisation knowledge varied between Registered Nurse/Midwives (RM/RN) 80% and Registered Midwives (RM) 48.90% (p = 0.001). Quantitative data showed that only 43% of midwives felt sufficiently educated to provide the vaccine. Midwives who had received formal immunisation training were more likely to recommend the vaccine 93.7% (p = 0.001). Qualitative data confirmed these results and identified the lack of immunisation education as a barrier to practise. Conclusion: Midwives identified an immunisation knowledge deficit. Midwives who had received immunisation education were more likely to actively promote and provide the vaccine to pregnant women. These findings indicate the need for more immunisation education of midwives in both tertiary and practice settings.

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Australian caregivers’ perceptions of influenza vaccination in pregnancy: A mixed methods exploration

Cited by 5 publications

References 23 publications

Vaccine discussions in pregnancy: interviews with midwives to inform design of an intervention to promote uptake of maternal and childhood vaccines

Vaccine discussions in pregnancy: interviews with midwives to inform design of an intervention to promote uptake of maternal and childhood vaccines

Understanding Barriers and Facilitators to Maternal Immunization: A Systematic Narrative Synthesis of the Published Literature

An exploration of midwives’ role in the promotion and provision of antenatal influenza immunisation: A mixed methods inquiry

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