Factors influencing women's decisions regarding pertussis vaccine: A decision-making study in the Postpartum Pertussis Immunization Program of a teaching hospital in Taiwan

Cheng, Po‐Jen; Shaw, Sheng-Wen; Kao, Chuan-Chi; Chueh, Ho-Yen; Chang, Shuenn‐Dyh; Hsu, Te‐Yao; Kung, Fu‐Tsai; Hsieh, T’sang‐T’ang

doi:10.1016/j.vaccine.2010.05.078

Cited by 31 publications

(32 citation statements)

References 20 publications

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“…An increased concern about disease severity increases the likelihood of being immunized during pregnancy, 28 while not feeling at risk of the disease decreased the likelihood of immunization. 22,[29][30][31][32][33][34] Lack of awareness of personal risk was commonly noted in relation to influenza vaccine, particularly during the 2009 H1N1 pandemic. Lack of knowledge about the disease, vaccine, and risk of infection was commonly cited in studies related to influenza and pertussis.…”

Section: Factors Related To Pregnant Womenmentioning

confidence: 99%

“…28,29,[34][35][36][37][38][39][40][41] Most women identified safety concerns such as side effects as the greatest barrier to immunization during pregnancy. [29][30][31][32][35][36][37][38]42,43,45,46 While women were concerned about their own safety 25,30,34,37,[44][45][46]51,52 or prior adverse events with the vaccine, 46,47 safety concerns for the fetus and newborn were paramount. 22,25,30,31,34,39,[44][45][46]51,52 Doubt about the effectiveness of the vaccine was particularly noted with influenza vaccine.…”

Section: Factors Related To Pregnant Womenmentioning

confidence: 99%

“…[29][30][31][32][35][36][37][38]42,43,45,46 While women were concerned about their own safety 25,30,34,37,[44][45][46]51,52 or prior adverse events with the vaccine, 46,47 safety concerns for the fetus and newborn were paramount. 22,25,30,31,34,39,[44][45][46]51,52 Doubt about the effectiveness of the vaccine was particularly noted with influenza vaccine. 22,25,32,34,35 General mistrust of vaccinations 37 was mentioned in studies related to influenza, 29 pertussis, 30 and group B Streptococcus.…”

Section: Factors Related To Pregnant Womenmentioning

confidence: 99%

“…22,25,30,31,34,39,[44][45][46]51,52 Doubt about the effectiveness of the vaccine was particularly noted with influenza vaccine. 22,25,32,34,35 General mistrust of vaccinations 37 was mentioned in studies related to influenza, 29 pertussis, 30 and group B Streptococcus. 49 In some women, fear of needles presented a barrier to any immunization, including those given during pregnancy.…”

Section: Factors Related To Pregnant Womenmentioning

confidence: 99%

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Improving rates of maternal immunization: Challenges and opportunities

MacDougall

Halperin

2015

Human Vaccines & Immunotherapeutics

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Objectives: An increasing number of vaccines are recommended or are being developed for use during pregnancy to protect women, fetuses, and/or newborns. For vaccines that are already recommended, vaccine uptake is variable and well below desired target. We reviewed the literature related to factors that affect a healthcare provider's recommendation and a woman's willingness to be vaccinated during pregnancy. Design: A scoping review of published literature from 2005 to 2015 was undertaken and all relevant articles were abstracted, summarized, and organized thematically. Results: Barriers and facilitators were identified that either decreased or increased the likelihood of a healthcare provider offering and a pregnant woman accepting vaccination during pregnancy. Concern about the safety of vaccines given during pregnancy was the most often cited barrier among both the public and healthcare providers. Other barriers included doubt about the effectiveness of the vaccine, lack of knowledge about the burden of disease, and not feeling oneself to be at risk of the infection. Major facilitators for maternal immunization included specific safety information about the vaccine in pregnant women, strong national recommendations, and healthcare providers who both recommended and provided the vaccine to their patients. Systems barriers such as inadequate facilities and staffing, vaccine purchase and storage, and reimbursement for vaccination were also cited. Evidence-based interventions were few, and included text messaging reminders, chart reminders, and standing orders. Conclusions: In order to have an effective vaccination program, improvements in the uptake of recommended vaccines during pregnancy are needed. A maternal immunization platform is required that normalizes vaccination practice among obstetrical care providers and is supported by basic and continuing education, communication strategy, and a broad range of research.

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Section: Factors Related To Pregnant Womenmentioning

confidence: 99%

Section: Factors Related To Pregnant Womenmentioning

confidence: 99%

Section: Factors Related To Pregnant Womenmentioning

confidence: 99%

Section: Factors Related To Pregnant Womenmentioning

confidence: 99%

See 2 more Smart Citations

Improving rates of maternal immunization: Challenges and opportunities

MacDougall

Halperin

2015

Human Vaccines & Immunotherapeutics

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“…Surveys of pregnant women have identified a number of factors associated with increased likelihood of immunization including prior vaccination status, 16,18 knowledge of vaccines and the diseases they prevent, 16,[19][20][21] perceived susceptibility to vaccine preventable illnesses 15,16,19 and healthcare provider (HCP) recommendation. [21][22][23] Lack of trust in vaccine information 19,24 and in the safety and effectiveness of vaccines are factors associated with reduced likelihood of maternal immunization during pregnancy. 23,24 These factors align with what is known about parental decision-making for childhood immunization 25 and the decision-making process adults undertake on their own behalf about vaccination.…”

Section: Introductionmentioning

confidence: 99%

Increased awareness and health care provider endorsement is required to encourage pregnant women to be vaccinated

Collins

Alona

Tooher

et al. 2014

Human Vaccines & Immunotherapeutics

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Maternal immunization is an important strategy recommended to protect both mothers and infants from serious infectious diseases; however uptake of maternal immunization is poor in Australia. This study aimed to gain an in-depth understanding of the decision making process and factors influencing a pregnant woman's decisions about recommended immunizations. This qualitative study used semi-structured interviews with open-ended questions to interview pregnant women. Data were analyzed using thematic analysis techniques and drew on the Health Belief Model. Pregnant women (n D 17) were asked about their attitudes toward immunization during pregnancy and their perceptions about risk during pregnancy. Women were also asked to detail their decision making process and factors influencing their decisions about immunizations in relation to pregnancy. Most of the participants were not aware of the immunizations recommended during pregnancy, in pregnancy planning or after delivery. In addition to endorsement by their health care provider (HCP), perception of risk and benefit, including risk of infection, previous vaccination experiences and assessing cost benefit play a vital role in women's decisions whether to be immunized while pregnant. Although the role of the healthcare provider in advising pregnant women about immunizations was identified as vitally important, the majority of women had not been advised of recommended vaccines by their healthcare provider. Healthcare providers are key to ensuring pregnant mothers are informed about recommended vaccines and these need to be more proactively supported and encouraged by healthcare providers. This is likely to have a positive effect on acceptance and uptake of immunization by pregnant women.

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Provider insight on surmounting specialty practice challenges to improve Tdap immunization rates among pregnant women

Mehrotra

Fisher

Mullen

et al. 2018

Heliyon

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BackgroundPertussis, or “whooping cough,” is an acute, contagious pulmonary disease that, despite being vaccine-preventable, has become an increasingly widespread problem in the United States. As a result, the Advisory Committee on Immunization Practices and American College of Obstetricians and Gynecologists updated recommendations stating clinicians should give a Tdap dose during every pregnancy, preferably at 27–36 weeks. Despite this recommendation, reported Tdap vaccine receipt rates during pregnancy vary from 16–61%, and previous studies have shown that clinician recommendation and vaccine administration are strongly associated with vaccine uptake among pregnant women.MethodsOur aim was to inform new strategies to increase uptake of the Tdap vaccine among pregnant women and, ultimately, reduce pertussis-related morbidity and mortality in infants. We conducted interviews with a sample of 24 ob-gyns. We subsequently performed grounded theory analyses of transcripts using deductive and inductive coding strategies followed by intercoder reliability assessment.ResultsAll physicians interviewed were familiar with the most recent recommendation of giving the Tdap vaccine during the third trimester of every pregnancy, and the majority of physicians stated that they felt that the vaccine was important and effective due to the transfer of pertussis antibodies from the mother to the fetus. Most physicians indicated that they recommended the vaccine to patients during pregnancy, but not all reported administering it on site because it was not stocked at their practice. Implementation challenges for physicians included insurance reimbursement and other challenges (i.e., patient refusal). Tdap vaccination during pregnancy was a lower clinical priority for some physicians. Physicians recognized the benefits associated with Tdap vaccination during pregnancy.ConclusionsFindings indicate while most ob-gyns recognize the benefits of Tdap and recommend vaccination during pregnancy, barriers such as insurance reimbursement and financial concerns for the practice can outweigh the perceived benefits. This resulted in some ob-gyns reporting choosing not to stock and administer the vaccine in their practice. Recommendations to address these concerns include 1) structural support for Tdap vaccine administration in ob-gyns practices; 2) Continuing medical education-equivalent educational interventions that address management techniques, vaccine coding, and other relevant information; and 3) interventions to assist physicians in communicating the importance of Tdap vaccination during pregnancy.

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Factors influencing women's decisions regarding pertussis vaccine: A decision-making study in the Postpartum Pertussis Immunization Program of a teaching hospital in Taiwan

Cited by 31 publications

References 20 publications

Improving rates of maternal immunization: Challenges and opportunities

Improving rates of maternal immunization: Challenges and opportunities

Increased awareness and health care provider endorsement is required to encourage pregnant women to be vaccinated

Provider insight on surmounting specialty practice challenges to improve Tdap immunization rates among pregnant women

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