Influenza and pertussis vaccination during pregnancy – attitudes, practices and barriers in gynaecological practices in Germany

Abstract

Background In Germany, antenatal influenza vaccination is recommended since 2010, but uptake remains low. Several countries recently introduced antenatal pertussis vaccination, which is currently under consideration in Germany. We conducted a survey among gynaecologists on attitudes, practices and barriers regarding influenza and pertussis vaccination during pregnancy. Methods Gynaecologists were invited to complete a pre-tested, 24-item questionnaire published in the German Professional Association of Gynaecologists’ journal in September 2017 within 2 months. Associations between variables were examined using Chi-Squared, Fischer’s Exact or t-tests. Variables associated with gynaecologists’ self-reported implementation of vaccination in pregnant women were identified using univariate and multivariate logistic regression analyses. Results Of 867 participants (response 11%), 91.4 and 59.4% reported currently vaccinating pregnant women against influenza and pertussis, respectively. Gynaecologists who reported obtaining annual influenza vaccination and actively informing their patients about these vaccinations were significantly more likely to vaccinate pregnant women against influenza (96.5% vs. 65.7 and 95.1% vs. 62.2%) and pertussis (63.1% vs. 44.3 and 82.4% vs. 12.9%). Performing influenza vaccination was least likely among gynaecologists who perceived logistical difficulties as a vaccination barrier (35.9%), while pertussis vaccination was least likely if the lacking official recommendation (32.0%), logistical difficulties (27.1%), safety concerns (17.5%) and limited vaccine effectiveness (11.1%) were perceived as barriers. Of participants not yet vaccinating pregnant women against pertussis, 86.5% reported they would follow an official recommendation. Including vaccination recommendations in the maternity record (95.2%) and informing the public (88.7%) and health care professionals (86.6%) were considered the most suitable measures to achieve high pertussis vaccination coverage. Conclusions The large proportion reporting performance of influenza vaccination during pregnancy and high acceptance of a potential recommendation for pertussis vaccination reflected positive attitudes towards vaccination among participants. However, factors associated with failure to vaccinate may be more prevalent among non-participants. Results suggest that gynaecologists’ confidence in vaccination is crucial for implementing vaccination in pregnancy. Thus, doubts on vaccine effectiveness and safety should be allayed among gynaecologists and pregnant women via various communication channels, and solutions for logistical barriers sought. Including antenatal vaccination recommendations in the maternity record would serve as an important reminder for both groups. Electronic supplementary material The online version of this article (10.1186/s12913-019-4437-y) contains supplementary material, which is avail...

Vaccinations and Chronic Diseases: Knowledge, Attitudes, and Self-Reported Adherence among Patients in Italy

“…Consistent with recent literature was the impact of physicians' recommendation on adherence among different at-risk groups [9,[36][37][38]. However, several barriers have been reported by physician to discussing vaccination with these patients, such as, for example, lack of time, lack of an effective reminder system, patients' absence from regular visits, and clinical status [39][40][41]. This is of particular importance since general practitioners and specialists play a key role in the immunization landscape and should be influential sources given that patients may receive untrustworthy information.…”

Influenza Vaccination Experiences of Pregnant Women as a Predictor of the Intention to Become Vaccinated in Future Pregnancies in Spain

“…The flu vaccination recommendation was directly provided by the midwife during the consultation [ 31 , 32 ]. We believe that a professional health worker with knowledge and skills obtains significantly higher vaccination coverage.…”

“…As for the flu vaccine, we received responses such as “it is not an effective or necessary vaccine” and “I have doubts or mistrust about its safety”, which represented more than half of the reasons provided for rejecting it in future occasions [ 27 , 32 , 42 ]. Pregnant women differ from those who are not, because they have concerns about the safety of vaccines for the fetus, and some prefer not to become vaccinated during pregnancy [ 11 ].…”

“…Pregnant women differ from those who are not, because they have concerns about the safety of vaccines for the fetus, and some prefer not to become vaccinated during pregnancy [ 11 ]. Key aspects for improving the low flu vaccine coverage of the pregnant women include knowing the reasons provided by the women who rejected the vaccine, having health professionals who are trained to provide answers to their doubts, provide more opportunities for vaccination and include prenatal vaccine recommendations, creating a vaccine history for every woman [ 32 ]. Professional monitoring after immunization is an influencing factor in future maternal vaccinations, also considering the repetition of the doses or the increase in the number of new vaccines in this period of life of the women [ 27 ].…”

Pertussis in the Voronezh Region: Epidemiology and Vaccination

“…Активно в развитых странах мира внедряется стратегия вакцинопрофилактики по типу «кокона» -вакцинация всех членов семьи новорожденного, в связи с тем, что они являются потенциальными источниками инфекции для своих младенцев [21]. Однако до настоящего времени охват беременных прививками остается низким [22]. Но если вакцинация беременных против коклюша является поводом для дискуссии, то необходимость вакцинации и ревакцинации детей не вызывает сомнений [23].…”