Uptake of vaccination in pregnancy

Sebghati, Mercede; Khalil, Asma

doi:10.1016/j.bpobgyn.2021.03.007

Cited by 55 publications

(55 citation statements)

References 26 publications

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“…These results show a considerable improvement in vaccination adherence in comparison with data reported in Sicily by the Regional Health department due to the educational interventions conducted (<2.5% for DTPa and lower for influenza vaccination). In United Kingdom, during the 2018/2019 season, vaccine coverage in pregnant women against pertussis was higher than 70% and against flu was 45.2%, while in the US 61.2% of pregnant women received influenza vaccination during 2019/2020 season, rate similar to what observed in our sample after the educational interventions conducted [29].…”

Section: Discussionsupporting

confidence: 86%

Educational Interventions on Pregnancy Vaccinations during Childbirth Classes Improves Vaccine Coverages among Pregnant Women in Palermo’s Province

et al. 2021

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Maternal immunization is considered the best intervention in order to prevent influenza infection of pregnant women and influenza and pertussis infection of newborns. Despite the existing recommendations, vaccination coverage rates in Italy remain very low. Starting from August 2018, maternal immunization against influenza and diphtheria-tetanus-pertussis were strongly recommended by the Italian Ministry of Health. We conducted a cross sectional study to estimate the effectiveness of an educational intervention, conducted during childbirth classes in three general hospitals in the Palermo metropolitan area, Italy, on vaccination adherence during pregnancy. To this end, a questionnaire on knowledge, attitudes, and immunization practices was structured and self-administered to a sample of pregnant women attending childbirth classes. Then, an educational intervention on maternal immunization, followed by a counseling, was conducted by a Public Health medical doctor. After 30 days following the interventions, the adherence to the recommended vaccinations (influenza and pertussis) was evaluated. At the end of the study 326 women were enrolled and 201 responded to the follow-up survey. After the intervention, among the responding pregnant women 47.8% received influenza vaccination (+44.8%), 57.7% diphtheria-tetanus-pertussis vaccination (+50.7%) and 64.2% both the recommended vaccinations (+54.8%). A significant association was found between pregnant women that received at least one vaccination during pregnancy and higher educational level (graduation degree/master’s degree), employment status (employed part/full-time) and influenza vaccination adherence during past seasons (at least one during last five years). The implementation of vaccination educational interventions, including counseling by healthcare professionals (HCPs), on maternal immunization during childbirth courses improved considerably the vaccination adherence during pregnancy.

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Section: Discussionsupporting

confidence: 86%

Educational Interventions on Pregnancy Vaccinations during Childbirth Classes Improves Vaccine Coverages among Pregnant Women in Palermo’s Province

et al. 2021

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“…Argentina observed a relative reduction of 44% in the incidence of pertussis among children 2-6 months of age after it began vaccinating pregnant with Tdap in 2012 [81]. In the UK, the incidence of pertussis in infants <3 months of age declined overall from 234 per 100,000 in 2012 to 52 per 100,000 in 2019 [82]. At KPNC, incidence rates of pertussis among infants <1 year during 2010 to 2018 declined from more than 148/100,000 person-years to 25/100,000 personyears (Figure 2).…”

Section: Strategies With Successful Results: Maternal Tdap Vaccination During Pregnancymentioning

confidence: 99%

“…A recent survey among women in the US who were pregnant in 2018-2019 and delivered live-born infants reported that only 56% received a Tdap vaccine [87]. In the UK, in 2020, the average vaccine uptake was 70.5% [82]. We need strategies to increase vaccine uptake.…”

Section: Need To Increase Maternal Vaccination During Pregnancymentioning

confidence: 99%

Lessons from a mature acellular pertussis vaccination program and strategies to overcome suboptimal vaccine effectiveness

Zerbo

Fireman

Klein

2021

Expert Review of Vaccines

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Introduction: Despite high vaccination coverage among children and adolescents, pertussis remains a public health problem, with large outbreaks occurring periodically in the US and other developed countries. Areas covered: We examine lessons learned more than 20 years after implementation of programs which use only acellular pertussis vaccines and propose avenues for possible effective use of acellular pertussis vaccine to prevent large outbreaks. Expert Opinion: Acellular pertussis vaccines were introduced more than 20 years ago, yet the incidence of pertussis has been increasing over the past decade, with periodic large outbreaks marked by notable shifts in disease burden from infants and young children toward fully vaccinated adolescents and young adults. This age shift is mainly driven by the waning of vaccine immunity. To better protect adolescents against pertussis, modification of the current acellular pertussis vaccination schedule or adoption of new vaccination strategies should be considered. For infants not yet eligible to be vaccinated, maternal vaccination against pertussis during pregnancy is an effective way to protect infants from infection, severe disease and death. Implementation of maternal vaccination programs should be encouraged in countries without one or efforts to improve coverage should be supported in countries with existing program.

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“…Complications from influenza infections can also lead to pneumonia in children. Despite this, uptake of the influenza vaccine by pregnant women and in children up to 3 years of age remains relatively low, with coverage of approximately 44% in both populations [ 51 , 53 ].…”

Section: Discussionmentioning

confidence: 99%

Associations between gestational age at birth and infection-related hospital admission rates during childhood in England: Population-based record linkage study

et al. 2021

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Background Children born preterm (<37 completed weeks’ gestation) have a higher risk of infection-related morbidity than those born at term. However, few large, population-based studies have investigated the risk of infection in childhood across the full spectrum of gestational age. The objectives of this study were to explore the association between gestational age at birth and infection-related hospital admissions up to the age of 10 years, how infection-related hospital admission rates change throughout childhood, and whether being born small for gestational age (SGA) modifies this relationship. Methods and findings Using a population-based, record-linkage cohort study design, birth registrations, birth notifications and hospital admissions were linked using a deterministic algorithm. The study population included all live, singleton births occurring in NHS hospitals in England from January 2005 to December 2006 (n = 1,018,136). The primary outcome was all infection-related inpatient hospital admissions from birth to 10 years of age, death or study end (March 2015). The secondary outcome was the type of infection-related hospital admission, grouped into broad categories. Generalised estimating equations were used to estimate adjusted rate ratios (aRRs) with 95% confidence intervals (CIs) for each gestational age category (<28, 28–29, 30–31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41 and 42 weeks) and the models were repeated by age at admission (<1, 1–2, 3–4, 5–6, and 7–10 years). An interaction term was included in the model to test whether SGA status modified the relationship between gestational age and infection-related hospital admissions. Gestational age was strongly associated with rates of infection-related hospital admissions throughout childhood. Whilst the relationship attenuated over time, at 7–10 years of age those born before 40 weeks gestation were still significantly higher in comparison to those born at 40 weeks. Children born <28 weeks had an aRR of 6.53 (5.91–7.22) during infancy, declining to 3.16 (2.50–3.99) at ages 7–10 years, in comparison to those born at 40 weeks; whilst in children born at 38 weeks, the aRRs were 1·24 (1.21–1.27) and 1·18 (1.13–1.23), during infancy and aged 7–10 years, respectively. SGA status modified the effect of gestational age (interaction P<0.0001), with the highest rate among the children born at <28 weeks and SGA. Finally, study findings indicated that the associations with gestational age varied by subgroup of infection. Whilst upper respiratory tract infections were the most common type of infection experienced by children in this cohort, lower respiratory tract infections (LRTIs) (<28 weeks, aRR = 10.61(9.55–11.79)) and invasive bacterial infections (<28 weeks, aRR = 6.02 (4.56–7.95)) were the most strongly associated with gestational age at birth. Of LRTIs experienced, bronchiolitis (<28 weeks, aRR = 11.86 (10.20–13.80)), and pneumonia (<28 weeks, aRR = 9.49 (7.95–11.32)) were the most common causes. Conclusions Gestational age at birth was strongly associated with rates of infection-related hospital admissions during childhood and even children born a few weeks early remained at higher risk at 7–10 years of age. There was variation between clinical subgroups in the strength of relationships with gestational age. Effective infection prevention strategies should include focus on reducing the number and severity of LRTIs during early childhood.

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Uptake of vaccination in pregnancy

Cited by 55 publications

References 26 publications

Educational Interventions on Pregnancy Vaccinations during Childbirth Classes Improves Vaccine Coverages among Pregnant Women in Palermo’s Province

Educational Interventions on Pregnancy Vaccinations during Childbirth Classes Improves Vaccine Coverages among Pregnant Women in Palermo’s Province

Lessons from a mature acellular pertussis vaccination program and strategies to overcome suboptimal vaccine effectiveness

Associations between gestational age at birth and infection-related hospital admission rates during childhood in England: Population-based record linkage study

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