Inequalities in maternal pertussis vaccination uptake: a cross-sectional survey of maternity units

McAuslane, Helen; Utsi, Lara; Wensley, Adrian; Coole, Louise

doi:10.1093/pubmed/fdx032

Cited by 18 publications

(23 citation statements)

References 6 publications

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“…This finding is also consistent with previous studies in different international contexts. 12,18,20,45 In England, Byrne et al found that women of Black-British and Black-Afro-Caribbean ethnicity had the lowest maternal pertussis vaccine coverage and reported that deprivation was linked to low maternal vaccine coverage. 17 Black-Afro Caribbean women's vaccine hesitancy might relate to wider feelings of discrimination by the healthcare system associated with ethnicity and socio-economic deprivation.…”

Section: Discussionmentioning

confidence: 99%

“…12 Maternal vaccine uptake in England varies regionally and has been historically lower in London for both pertussis [13][14][15] and influenza. 16 Deprivation and ethnicity are known predictors of lower maternal pertussis vaccine uptake 17,18 as well as for maternal and child influenza vaccine uptake in England. 19 Previous work conducted by our group in London found low awareness and low maternal pertussis uptake with variation between different ethnicities, with the lowest uptake among Black Afro-Caribbean women 20 (a demographic group including Black African/Caribbean/Black British and women of any other Black background 21 ).…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of a midwife-led, hospital based vaccination service for pregnant women

Holder

Meinel

Narh

et al. 2020

Human Vaccines & Immunotherapeutics

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Background: Vaccines against whooping cough (pertussis) and seasonal-influenza are recommended for pregnant women in England. Uptake however varies regionally and by ethnicity. Pregnant women are traditionally vaccinated in primary care, though some hospitals now offer vaccines through antenatal clinics. This mixed-methods evaluation describes the demographic characteristics of women seen in a hospital midwife-led antenatal vaccine clinic and explores vaccine decision making. Methods: Descriptive statistics of women seen in a London hospital's midwife-led vaccine clinic were generated from electronic routine maternity records, including data on ethnicity, parity, age and deprivation indices. Reasons for vaccine decline given by women to midwives were categorized by themes. Qualitative interviews of women seen in the clinic were also undertaken. Results: Between 1st April 2017 and 31st March 2018 the vaccine clinic saw 1501 pregnant women. Of these, 83% received pertussis vaccine and (during flu season) 51% received influenza vaccine, from the clinic. Fewer Black Afro-Caribbean women seen by the clinic were vaccinated, compared to other ethnicities with only 68% receiving pertussis and 34% flu vaccines respectively (p < .05). Among all women delivering at the hospital over the year, 42%, (1334/3147) were vaccinated by the clinic. Qualitative interviews found that reassurance from healthcare professionals, particularly midwives, was the most important factor influencing maternal vaccine decisions. Conclusions: Midwife-led hospital clinics can offer an effective alternative to primary care provision for vaccines in pregnancy. Consistent with previous work, vaccine uptake varied by ethnicity. Midwives play a key role in the provision of vaccine services and influence women's vaccine decisions.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of a midwife-led, hospital based vaccination service for pregnant women

Holder

Meinel

Narh

et al. 2020

Human Vaccines & Immunotherapeutics

View full text Add to dashboard Cite

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“…In addition to ethnicity, it has also been reported that antenatal vaccination uptake is affected by other factors such as parity and deprivation [ 43 ]. McAuslane et al.…”

Section: Maternal Vaccinationmentioning

confidence: 99%

“…reported that pertussis vaccine uptake was significantly lower in women with parity greater than three (48.1%; 95% CI 37.0–59.4) than in those with parity between one to three (63.0%; 95% CI 58.3–67.5). The same study also found that vaccine uptake was lowest in the most deprived quintile at 52.1% (95% CI 40.2–63.9) when compared with the least deprived quintile at 69.0% (95% CI 60.3–76.5), but this difference was not statistically significant [ 43 ].…”

Section: Maternal Vaccinationmentioning

confidence: 99%

Uptake of vaccination in pregnancy

Sebghati

Khalil

2021

Best Practice & Research Clinical Obstetrics & Gynaecol

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Maternal immunisation is a public health strategy that aims to provide protection against certain infections to both mother and her foetus or newborn child. Vaccination of pregnant women induces vaccine-specific antibodies that lead to the subsequent transfer of these antibodies across the placenta or through breastfeeding to the offspring. At present, vaccinations in pregnancy are limited to pertussis, tetanus, diphtheria, polio, and the seasonal Influenza vaccine. Recently, some countries have incorporated routine antenatal vaccinations in their national immunisation programmes. Future vaccines targeted at pregnant women such as respiratory syncytial virus (RSV) and Group B streptococcus (GBS) are under development. The recently approved Covid-19 vaccines have no safety data for use in pregnancy at present, but have been considered in the UK in extremely vulnerable pregnant women or pregnant frontline health and social care workers. In this article, we review the evidence supporting maternal immunisation and discuss the uptake of vaccines in pregnant women, challenges of recording the data on vaccine coverage, and consider reasons behind the present levels of uptake and strategies for future improvements.

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“…17 18 Smaller studies of pertussis and seasonal influenza vaccines have suggested deprivation, ethnicity, maternal age and parity or number of children may be factors in maternal vaccine uptake, but have lacked power to describe these associations fully. [19][20][21][22][23] A better understanding of the social determinants of maternal vaccine uptake could inform targeted public health interventions to improve vaccine uptake and reduce health inequalities.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Social determinants of pertussis and influenza vaccine uptake in pregnancy: a national cohort study in England using electronic health records

et al. 2021

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ObjectiveTo examine the social determinants of influenza and pertussis vaccine uptake among pregnant women in England.DesignNationwide population-based cohort study.SettingThe study used anonymised primary care data from the Clinical Practice Research Datalink and linked Hospital Episode Statistics secondary care data.ParticipantsPregnant women eligible for pertussis (2012–2015, n=68 090) or influenza (2010/2011–2015/2016, n=152 132) vaccination in England.Main outcome measuresInfluenza and pertussis vaccine uptake.ResultsVaccine uptake was 67.3% for pertussis and 39.1% for influenza. Uptake of both vaccines varied by region, with the lowest uptakes in London and the North East. Lower vaccine uptake was associated with greater deprivation: almost 10% lower in the most deprived quintiles compared with the least deprived for influenza (34.5% vs 44.0%), and almost 20% lower for pertussis (57.7% vs 76.0%). Lower uptake for both vaccines was also associated with non-white ethnicity (lowest among women of black ethnicity), maternal age under 20 years and a greater number of children in the household. The associations between all social factors and vaccine uptake were broadly unchanged in fully adjusted models, suggesting the social determinants of uptake were largely independent of one another. Among 3111 women vaccinated against pertussis in their first eligible pregnancy and pregnant again, 1234 (40%) were not vaccinated in their second eligible pregnancy.ConclusionsTargeting promotional campaigns to pregnant women who are younger, of non-white ethnicity, with more children, living in areas of greater deprivation or the London or North East regions, has potential to reduce vaccine-preventable disease among infants and pregnant women, and to reduce health inequalities. Vaccination promotion needs to be sustained across successive pregnancies. Further research is needed into whether the effectiveness of vaccine promotion strategies may vary according to social factors.

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Inequalities in maternal pertussis vaccination uptake: a cross-sectional survey of maternity units

Abstract: Pertussis vaccine uptake in pregnant women varies significantly across the country and is affected by ethnicity, deprivation and parity. Variations should be addressed through service delivery models designed to reduce potential inequalities in infant protection.

Cited by 18 publications

References 6 publications

Evaluation of a midwife-led, hospital based vaccination service for pregnant women

Evaluation of a midwife-led, hospital based vaccination service for pregnant women

Uptake of vaccination in pregnancy

Social determinants of pertussis and influenza vaccine uptake in pregnancy: a national cohort study in England using electronic health records

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