Maternal pertussis and influenza immunization coverage and attitude of health care workers towards these recommendations in Flanders, Belgium

Abstract

In Belgium, pertussis vaccination is recommended for all pregnant women in every pregnancy. Adults in close contact with young infants are equally advised to receive a pertussis containing booster dose. Maternal influenza vaccination is likewise recommended in Belgium in the second or third trimester of pregnancy, within the influenza season. A quantitative multicenter survey study has been performed between October 2014 and May 2015 in both postpartum women (N=823, response rate=89.2%) and health care workers (HCWs) (N=261) to assess the coverage of both vaccines during pregnancy along with the coverage of the pertussis cocoon strategy, and to evaluate the knowledge and recommending attitude of HCWs towards the maternal vaccination strategies and the cocoon strategy among surveyed women and HCWs. Overall coverage of pertussis vaccination during pregnancy was 64.0%. Most women were vaccinated by their general practitioner (GP) (82.4%), and most often in the third trimester (74.0%) of pregnancy. Overall coverage of influenza vaccination during pregnancy was 45.0%. Again the GP administered most vaccines (67.6%); vaccines were equally administered in the second or third trimester of pregnancy. Educational level had a significant influence on both the pertussis and influenza vaccination coverage during pregnancy while working situation and parity had only an influence on the maternal pertussis vaccination coverage and country of birth only on the maternal influenza vaccination coverage. Overall, 78.4% of gynecologists and GPs recommends both maternal pertussis and influenza vaccination and 67.0% recommends both maternal vaccination strategies and the cocoon strategy. Within the group of the midwives, only 23.7% recommends both maternal pertussis and influenza vaccination and 10.5% recommends both maternal vaccination strategies and the cocoon strategy. High coverage is reached among pregnant women for pertussis and influenza vaccination. Several underserved populations of pregnant women regarding maternal immunization, are identified.

Factors Affecting the Implementation Process of Pertussis [Tdap] Immunization in Pregnant Women in an Italian Region: A Qualitative Study

“…To mitigate this problem, a possible solution consists in the provision of auditable educational training to HCPs contributing to ANC services such as GPs, gynecologists and midwives, to improve their confidence and inclination to discuss vaccination with expectant mothers. A second critical issue, emphasized by many respondents, is the reported skeptical attitude toward vaccinations among midwives and gynecologists in their district: this is consistent with findings in the literature (27,28). For this reason, in order to understand why HCPs have this attitude, university courses designed for midwives and gynecologists should be revised.…”

Midwives’ knowledge, attitudes and learning needs regarding antenatal vaccination

“…For example, less than half of midwives in Ontario reported having sufficient knowledge of immunisation (Lee, Saskin et al 2005). A recent survey of health providers in Belgium found one-quarter of midwives recommended influenza and pertussis vaccines to their pregnant patients (Maertens, Braeckman et al 2016), and a similar study from Canada suggested midwives take a less active role in promoting immunisation compared to other healthcare providers (Dube, Vivion et al 2013). This study aimed to assess the knowledge, attitudes and learning needs of midwives in hospital X, the only public tertiary maternity hospital in the Australian state of XX.…”

Maternal vaccinations coverage and reasons for non-compliance - A cross-sectional observational study

“…but still falls short of national target rates aiming for universal coverage of >90%. In uenza coverage, on the other hand, is far from satisfactory even when compared to coverage in other countries like the United States (49.1% 13 ) or Belgium (45% 18 ).…”