RESUMO
BACKGROUND: Vaccination against influenza and pertussis in pregnancy can reduce the significant morbidity and mortality associated with these infections. Despite this, there is poor uptake of both vaccines in pregnancy. AIM: To explore women's perception of vaccination in pregnancy and thereby determine the reasons behind such low vaccination rates. DESIGN & SETTING: This is a qualitative study undertaken at a large maternity hospital. METHOD: Seventeen post-partum women completed a semi-structured interview discussing vaccination. They were recruited from a quantitative study looking at vaccination rates in pregnancy. The interview transcripts were discussed among three researchers and underwent thematic analysis. RESULTS: Three themes emerged. The first theme explored the influencing factors that shaped the women's decision to vaccinate in pregnancy. The recommendation of a healthcare provider was the most important influencing factor for this study's cohort of women. The second theme highlighted the deficiency in knowledge women had regarding vaccine safety. The last theme related to the pertussis vaccine, and the reluctance of healthcare providers to discuss and offer this vaccine in pregnancy. CONCLUSION: The qualitative approach gives voice to the thoughts and concerns of women as they make the complex decision to vaccinate in pregnancy. Clinicians must be cognizant of the important role they play in advising women to vaccinate in pregnancy. They must advise women that the vaccine is safe and address any of their concerns. Lastly, a message on vaccine safety should be included in future public health campaigns to promote vaccination in pregnancy.
RESUMO
BACKGROUND: Influenza during pregnancy is a potentially life threatening illness. There are limited data on influenza vaccination uptake and determinants of uptake in Irish obstetric populations. AIM: To determine the uptake of influenza vaccination during pregnancy; determinants of vaccination uptake; knowledge, attitudes, and concerns of postnatal women; and knowledge and attitudes of healthcare professionals (HCPs) surrounding vaccination. DESIGN & SETTING: A quantitative study of postnatal women attending the Rotunda Hospital, a tertiary referral maternity hospital in Dublin, Ireland. A separate quantitative study conducted by the North Dublin City GP Training Programme surveyed GPs, pharmacists, and Rotunda Hospital clinical staff. METHOD: A paper-based survey was distributed to postnatal women. HCPs completed the survey via the online tool Survey Monkey. RESULTS: 330 patient surveys were disseminated, with a 60.0% response rate. Of 198 responders, 109 (55.1%) were vaccinated against influenza. Non-professionals were less likely to be vaccinated (adjusted odds ratio [aOR] 0.29, 95% confidence interval [CI] = 0.09 to 0.89). Vaccination in previous pregnancy (aOR 5.2, 95% CI = 1.69 to 15.62) and information from an HCP were strongly associated with vaccination (aOR 12.8, 95% CI = 2.65 to 62.5). There was a 20.2% (n = 1180) response rate among HCPs. More GPs felt that it was their role to discuss vaccination (92.9%; n = 676), and offer to vaccinate women (91.7%; n = 666) than any other HCP. CONCLUSION: Provision of information about the importance of vaccination against influenza and pertussis during pregnancy by HCPs and their consistent recommendations in support of vaccination were key determinants of vaccine uptake during pregnancy. The sociodemographic determinants of a woman's vaccination status should be addressed in health promotion campaigns. Education of HCPs may address knowledge gaps surrounding vaccination.
