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Oguz MM, Senel S. Effectiveness of cocoon strategy vaccination on prevention of influenza-like illness in young infants. Hum Vaccin Immunother 2024; 20:2350090. [PMID: 38738691 DOI: 10.1080/21645515.2024.2350090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 04/26/2024] [Indexed: 05/14/2024] Open
Abstract
During the initial half-year of their existence, infants cannot receive the influenza vaccine, yet they face the greatest susceptibility to severe influenza complications. In this study, we seek to determine whether influenza vaccination of maternal and household contacts is associated with a reduced risk of influenza-like illness (ILI) and severe acute respiratory infection (SARI) in infants. This work was prospectively conducted during the influenza season. A total of 206 infants were included in this study. The percentage of infants with only the mother vaccinated is 12.6% (n:26), and the percent of infants with all household contacts vaccinated is 16% (n:33). Among the infants with only the mother vaccinated, the effectiveness of influenza vaccine is estimated as 35.3% for ILI and 41.3% for SARI. Among infants with all household contacts vaccinated, the effectiveness is estimated as 48.9% for ILI and 76.9% for SARI. Based on the results of multivariate logistic regression analysis, all-household vaccination is a protective factor against SARI (OR: 0.07 95% CI [0.01-0.56]), household size (OR: 1.75, 95% CI [1.24-2.48]) and presence of secondhand smoke (OR: 2.2, 95% CI [1.12-4.45]) significant risk factors for SARI in infants. The mother alone being vaccinated is not a statistically significant protective factor against ILI (OR: 0.46, 95% CI [0.19-1.18]) or SARI (OR: 0.3, 95% CI [0.11-1.21]). Along with the obtained results and analysis, this study provides clear evidence that influenza vaccination of all household contacts of infants aged 0-6 months is significantly associated with protecting infants from both ILI and SARI.
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Affiliation(s)
- Melahat Melek Oguz
- Department of Pediatrics, Dr. Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Saliha Senel
- Department of Pediatrics, Yildirim Beyazit University, Ankara, Turkey
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2
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Scarso S, Marchetti G, Russo ML, D’Angelo F, Tosti ME, Bellini A, De Marchi C, Ferrari C, Gatta A, Caminada S, Papaevgeniou N, Dalma N, Karnaki P, Marceca M, Declich S. Access to Vaccination for Newly Arrived Migrants: Developing a General Conceptual Framework for Understanding How to Improve Vaccination Coverage in European Countries. Int J Public Health 2023; 68:1605580. [PMID: 37609078 PMCID: PMC10440383 DOI: 10.3389/ijph.2023.1605580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 07/20/2023] [Indexed: 08/24/2023] Open
Abstract
Objectives: Access to vaccination for newly arrived migrants (NAMs) is a relevant concern that requires urgent attention in EU/EEA countries. This study aimed to develop a General Conceptual Framework (GCF) for understanding how to improve vaccination coverage for NAMs, by characterizing and critically analyzing system barriers and possible strategies to increase vaccination. Methods: A theoretical conceptualization of the GCF was hypothesized based on conceptual hubs in the immunization process. Barriers and solutions were identified through a non-systematic desktop literature review and qualitative research. The GCF guided the activities and facilitated the integration of results, thereby enriching the GCF with content. Results: The study explores the vaccination of NAMs and proposes strategies to overcome barriers in their vaccination process. It introduces a framework called GCF, which consists of five interconnected steps: entitlement, reachability, adherence, achievement, and evaluation of vaccination. The study also presents barriers and solutions identified through literature review and qualitative research, along with strategies to enhance professionals' knowledge, improve reachability, promote adherence, achieve vaccination coverage, and evaluate interventions. The study concludes by recommending strategies such as proximity, provider training, a migrant-sensitive approach, and data collection to improve vaccination outcomes for NAMs. Conclusion: Ensuring equitable access to healthcare services, including vaccination, is crucial not only from a humanitarian perspective but also for the overall public health of these countries.
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Affiliation(s)
- Salvatore Scarso
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Giulia Marchetti
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Maria Laura Russo
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Franca D’Angelo
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
| | - Maria Elena Tosti
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
| | - Arianna Bellini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Chiara De Marchi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Caterina Ferrari
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Angela Gatta
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Susanna Caminada
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
| | - Nikoletta Papaevgeniou
- Prolepsis Institute for Preventive Medicine and Environmental and Occupational Health, Marousi, Greece
| | - Nadia Dalma
- Prolepsis Institute for Preventive Medicine and Environmental and Occupational Health, Marousi, Greece
| | - Pania Karnaki
- Prolepsis Institute for Preventive Medicine and Environmental and Occupational Health, Marousi, Greece
| | - Maurizio Marceca
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Roma, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
| | - Silvia Declich
- National Center for Global Health, National Institute of Health (ISS), Rome, Italy
- Italian Society of Migration Medicine (SIMM), Rome, Italy
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3
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McHugh L, Regan AK, Sarna M, Moore HC, Van Buynder P, Pereira G, Blyth CC, Lust K, Andrews RM, Crooks K, Massey P, Binks MJ. Inequity of antenatal influenza and pertussis vaccine coverage in Australia: the Links2HealthierBubs record linkage cohort study, 2012-2017. BMC Pregnancy Childbirth 2023; 23:314. [PMID: 37150828 PMCID: PMC10164451 DOI: 10.1186/s12884-023-05574-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 04/04/2023] [Indexed: 05/09/2023] Open
Abstract
BACKGROUND Pregnancy and early infancy are increased risk periods for severe adverse effects of respiratory infections. Aboriginal and/or Torres Strait Islander (respectfully referred to as First Nations) women and children in Australia bear a disproportionately higher burden of respiratory diseases compared to non-Indigenous women and infants. Influenza vaccines and whooping cough (pertussis) vaccines are recommended and free in every Australian pregnancy to combat these infections. We aimed to assess the equity of influenza and/or pertussis vaccination in pregnancy for three priority groups in Australia: First Nations women; women from culturally and linguistically diverse (CALD) backgrounds; and women living in remote areas or socio-economic disadvantage. METHODS We conducted individual record linkage of Perinatal Data Collections with immunisation registers/databases between 2012 and 2017. Analysis included generalised linear mixed model, log-binomial regression with a random intercept for the unique maternal identifier to account for clustering, presented as prevalence ratios (PR) and 95% compatibility intervals (95%CI). RESULTS There were 445,590 individual women in the final cohort. Compared with other Australian women (n = 322,848), First Nations women (n = 29,181) were less likely to have received both recommended antenatal vaccines (PR 0.69, 95% CI 0.67-0.71) whereas women from CALD backgrounds (n = 93,561) were more likely to have (PR 1.16, 95% CI 1.10-1.13). Women living in remote areas were less likely to have received both vaccines (PR 0.75, 95% CI 0.72-0.78), and women living in the highest areas of advantage were more likely to have received both vaccines (PR 1.44, 95% CI 1.40-1.48). CONCLUSIONS Compared to other groups, First Nations Australian families, those living in remote areas and/or families from lower socio-economic backgrounds did not receive recommended vaccinations during pregnancy that are the benchmark of equitable healthcare. Addressing these barriers must remain a core priority for Australian health care systems and vaccine providers. An extension of this cohort is necessary to reassess these study findings.
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Affiliation(s)
- Lisa McHugh
- School of Public Health, Division of Medicine, University of Queensland, Brisbane, Qld, 4001, Australia.
| | - Annette K Regan
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
- School of Nursing and Health Professions, University of San Francisco, San Francisco, CA, USA
- Wesfarmers Centre for Vaccines & Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Mohinder Sarna
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
- Wesfarmers Centre for Vaccines & Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Hannah C Moore
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
- Wesfarmers Centre for Vaccines & Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
| | - Paul Van Buynder
- School of Medicine and Dentistry, Griffith University, Southport, QLD, Australia
| | - Gavin Pereira
- Curtin School of Population Health, Curtin University, Perth, WA, Australia
- enAble Institute, Curtin University, Perth, WA, Australia
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Christopher C Blyth
- Wesfarmers Centre for Vaccines & Infectious Diseases, Telethon Kids Institute, Perth, WA, Australia
- School of Medicine, The University of Western Australia, Perth, WA, Australia
- Department of Paediatric Infectious Diseases, Perth Children's Hospital, Perth, WA, Australia
- Department of Microbiology, PathWest Laboratory Medicine, Perth, WA, Australia
| | - Karin Lust
- Women's and Newborn Service, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
- Department of Medicine, The University of Queensland, Brisbane Queensland, Australia
| | - Ross M Andrews
- Australian National University Canberra, Canberra, Australia
| | - Kristy Crooks
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Peter Massey
- College of Medicine and Dentistry, James Cook University, Queensland, Australia
| | - Michael J Binks
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
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4
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Smith SE, Sivertsen N, Lines L, De Bellis A. Decision making in vaccine hesitant parents and pregnant women - An integrative review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2022; 4:100062. [PMID: 38745627 PMCID: PMC11080481 DOI: 10.1016/j.ijnsa.2022.100062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 01/03/2022] [Accepted: 01/14/2022] [Indexed: 12/01/2022] Open
Abstract
Objectives : Vaccine refusal is increasing in Australia and is a major concern in high- and middle-income countries. There is evidence to suggest that some parents, even those who elect to immunise, may be vaccine hesitant with some manipulating the schedule by excluding or delaying some vaccines. The aim of this review was to gain an understanding of factors that influence vaccine decision-making in pregnant women and parents of children. Design : An integrative review approach was used to produce an analysis of existing literature on vaccine decision-making in pregnancy and parents. As the broadest of review methods, an integrative review can include a range of experimental and non-experimental research, thereby ensuring the inclusion of data from multiple perspectives. Data Sources : Online databases were searched for research related to vaccine decision-making in pregnant women and parents. Original and review articles were sought that were published in English between 2015 and 2021. Reviewed articles included qualitative and quantitative studies and systematic reviews. No mixed methods papers were located or excluded from this review. Review methods : The review method was an integrative review informed by Coughlan. Results : Papers from thirteen predominantly high- and middle-income countries were selected for this review. A total of 31 articles fit the inclusion/exclusion criteria, including qualitative, quantitative and review articles. Three main themes were identified including the role of healthcare professionals, vaccine safety concerns and alternative influences. Alternative influences included: social media, friends and family, religion, conspiracy theories and salutogenic parenting. Findings suggest that high levels of anxiety are involved in vaccine decision-making with parents seeking information from multiple sources including healthcare professionals, friends and family and social media. Conclusions : Pregnancy is an ideal time to provide education on both pregnancy and childhood vaccinations. However, some parents reported dissatisfaction in their therapeutic relationships with healthcare professionals. As a result, parents can resort to their own information seeking, in the main via social media which has been linked to vaccine refusal. Additionally, some healthcare professionals report feeling inadequately prepared for the role of immunisation promotion and provision. Parental information seeking from non-traditional sources has been shown to result in the acquisition of misinformation, exposure to conspiracy theories, the inevitable loss of vaccine confidence and subsequent vaccine refusal.
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Affiliation(s)
- Susan E Smith
- Flinders University College of nursing and health science, Australia
| | - Nina Sivertsen
- Flinders University College of nursing and health science, Australia
- Arctic University of Norway, Rural and Remote Arctic Health, Campus Hammersfest
| | - Lauren Lines
- Flinders University College of nursing and health science, Australia
| | - Anita De Bellis
- Flinders University College of nursing and health science, Australia
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5
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Demir R, Kaya Odabaş R. A systematic review to determine the anti-vaccination thoughts of pregnant women and the reasons for not getting vaccinated. J OBSTET GYNAECOL 2022; 42:2603-2614. [PMID: 36018038 DOI: 10.1080/01443615.2022.2114327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The aim of this study was to determine the anti-vaccination thoughts of pregnant women and the reasons for not getting vaccinated. In this study, data was obtained by retrospectively scanning the cross-sectional and qualitative studies published in the databases of 'PubMed, Cochrane, EBSCOhost, ULAKBİM and Google Scholar' in Turkish and English languages between 2011-2021. The PRISMA method was used in the preparation of the systematic review. In the studies reviewed, it was determined that the rate of pregnant women who were against the vaccine ranged from 6.2% to 98.6%, and the opinions of pregnant women against vaccination and the reasons for not getting vaccinated are presented under seven themes. The results of the study were considered important in terms of showing that quality and important studies were carried out in the literature on the subject and that the data were presented.IMPACT STATEMENTWhat is already known on this subject? Today, with the global coronavirus pandemic, vaccines and their effects are on the agenda again. Especially in pregnant women, opposition to vaccination and not getting vaccinated have emerged for various reasons.What do the results of this study add? The anti-vaccine thoughts of the pregnant women and the reasons for not getting vaccinated were mostly as follows: insufficient level of knowledge, mistrust of vaccines, perception of low infection risk, misconceptions and beliefs about the safety, content, side effects and efficacy of vaccines, worry and fear about the side effects of vaccines, the thought that the vaccine will harm herself and the baby, causes arising from healthcare professionals, financial, temporal and logistical barriers.What the implications are of these findings for clinical practice and/or further research? Scientific studies that can provide comprehensive and strong evidence about vaccine hesitancy and its causes, methods of increasing social approval in vaccination, and solutions should be proposed in the light of these researches in the fight against vaccine rejection.
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Affiliation(s)
- Rukiye Demir
- Department of Midwifery, Faculty of Health Sciences, Canakkale Onsekiz Mart University, Canakkale, Turkiye
| | - Resmiye Kaya Odabaş
- Department of Midwifery, Faculty of Health Sciences, Kocaeli University, Kocaeli, Turkiye
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6
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Geoghegan S, Shuster S, Butler KM, Feemster KA. Understanding Barriers and Facilitators to Maternal Immunization: A Systematic Narrative Synthesis of the Published Literature. Matern Child Health J 2022; 26:2198-2209. [PMID: 36173503 PMCID: PMC9521012 DOI: 10.1007/s10995-022-03508-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2022] [Indexed: 11/24/2022]
Abstract
Introduction Vaccines are being developed against Group B Streptococcus and respiratory syncytial virus. These vaccines are designed to be given to pregnant women to protect infants; thus, their success depends on uptake in this population. Maternal immunization programs have struggled to achieve target coverage rates. This systematic narrative synthesis aims to define the most important barriers and facilitators for maternal immunization and to identify priority areas for future research. Methods A search strategy was developed in Medline and adapted according to the requirements of additional search engines. Two reviewers independently reviewed the studies, using pre-specified inclusion and exclusion criteria. Results sections of included studies were coded, and thematic analysis was used to identify prominent themes. Results 321 studies were included in the final review. Most studies came from North America (37%), Europe (26%) or East Asia, Australia and New Zealand (22%). Low-and middle-income countries were under-represented. Five percent of studies came from Sub-Saharan Africa, and 2% came from South Asia. The prominent factors impacting maternal immunization were provider recommendation, perceived risks and benefits of maternal vaccines for the infant, race, birthplace, and access to healthcare. Few studies explored reasons behind racial and socioeconomic disparities in maternal immunization rates. Discussion A strong provider recommendation, equitable access to prenatal care and messaging that focuses on vaccine safety and infant benefits emerged as the key components for optimising vaccine uptake among pregnant women. Research among healthcare providers, minority groups and in low- and-middle-income countries was lacking. In anticipation of the expansion of maternal immunization programmes, focused research is needed to address these gaps and inform a successful public health strategy. Supplementary Information The online version contains supplementary material available at 10.1007/s10995-022-03508-0.
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Affiliation(s)
- Sarah Geoghegan
- Division of Infectious Diseases, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA. .,University College Dublin School of Medicine, Belfield, Dublin 4, Ireland.
| | - Sydney Shuster
- Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA
| | - Karina M Butler
- University College Dublin School of Medicine, Belfield, Dublin 4, Ireland.,Children's Health Ireland at Crumlin, Dublin 12, Ireland
| | - Kristen A Feemster
- Division of Infectious Diseases, Children's Hospital of Philadelphia, 3401 Civic Center Blvd., Philadelphia, PA, 19104, USA.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd., Building 421, Philadelphia, PA, 19104, USA.,Global Medical and Scientific Affairs, Merck Research Laboratories, Merck & Co., Inc, 351 North Sumneytown Pike, Upper Gwynedd, PA, 19454, USA
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7
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Tankwanchi ABS, Jaca A, Ndlambe AM, Zantsi ZP, Bowman B, Garrison MM, Larson HJ, Vermund SH, Wiysonge CS. Non-COVID-19 vaccine hesitancy among migrant populations worldwide: a scoping review of the literature, 2000-2020. Expert Rev Vaccines 2022; 21:1269-1287. [DOI: 10.1080/14760584.2022.2084075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
| | - Anelisa Jaca
- Cochrane South Africa, South African Medical Research Council, Cape Town, SA
| | - Asiphe M Ndlambe
- Cochrane South Africa, South African Medical Research Council, Cape Town, SA
| | - Zukiswa P Zantsi
- Cochrane South Africa, South African Medical Research Council, Cape Town, SA
| | - Brett Bowman
- Department of Psychology, School of Human and Community Development, University of the Witwatersrand, Johannesburg, SA
| | - Michelle M Garrison
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, USA
| | - Heidi J Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Sten H Vermund
- Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Charles S Wiysonge
- Cochrane South Africa, South African Medical Research Council, Cape Town, SA
- Department of Global Health, Stellenbosch University, Cape Town, SA
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, SA
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8
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Rajkumar V, McCausland K, Lobo R. A Rapid Review of Interventions to Increase Hepatitis B Testing, Treatment, and Monitoring among Migrants Living in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105947. [PMID: 35627481 PMCID: PMC9141177 DOI: 10.3390/ijerph19105947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/08/2022] [Accepted: 05/11/2022] [Indexed: 02/01/2023]
Abstract
Chronic hepatitis B (CHB) disproportionately affects migrants with low health literacy and help-seeking behaviour living in high-income countries. Evidence of effective interventions is required to increase hepatitis B (HBV) testing, treatment, and monitoring. Available evidence from Medline, Embase, Scopus, Google, and Google Scholar was identified, collated, and synthesised. Inclusion criteria included grey and peer-reviewed literature published in English between January 2012 and December 2021. Systematic reviews and meta-analyses were excluded. Seventeen peer-reviewed articles met the inclusion criteria. Most interventions were conducted at the individual level and were typically outreach testing initiatives. One study was conducted at a structural level. All studies were successful in encouraging HBV screening uptake, and 10 studies demonstrated effective linkage to care. Two studies showed evidence of monitoring participants post-intervention. Most interventions had more female than male participants. Interventions conducted across community and clinical-based settings had more participants engage in screening and/or linkage to care in community settings. Effective interventions to prevent HBV transmission and CHB-related morbidity and mortality were approaches that utilised linguistic-specific and culturally appropriate resources to successfully engage migrants. Community outreach programmes that educate participants about HBV transmission, screening, and treatment can promote community dialogue and understanding to reduce stigma and discrimination.
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Affiliation(s)
- Vishnupriya Rajkumar
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (K.M.); (R.L.)
- Correspondence:
| | - Kahlia McCausland
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (K.M.); (R.L.)
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Roanna Lobo
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (K.M.); (R.L.)
- Collaboration for Evidence, Research and Impact in Public Health (CERIPH), School of Population Health, Curtin University, Bentley, WA 6102, Australia
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9
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Esposito S, Abu Raya B, Baraldi E, Flanagan K, Martinon Torres F, Tsolia M, Zielen S. RSV Prevention in All Infants: Which Is the Most Preferable Strategy? Front Immunol 2022; 13:880368. [PMID: 35572550 PMCID: PMC9096079 DOI: 10.3389/fimmu.2022.880368] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/28/2022] [Indexed: 11/30/2022] Open
Abstract
Respiratory syncytial virus (RSV) causes a spectrum of respiratory illnesses in infants and young children that may lead to hospitalizations and a substantial number of outpatient visits, which result in a huge economic and healthcare burden. Most hospitalizations happen in otherwise healthy infants, highlighting the need to protect all infants against RSV. Moreover, there is evidence on the association between early-life RSV respiratory illness and recurrent wheezing/asthma-like symptoms As such, RSV is considered a global health priority. However, despite this, the only prevention strategy currently available is palivizumab, a monoclonal antibody (mAb) indicated in a subset of preterm infants or those with comorbidities, hence leaving the majority of the infant population unprotected against this virus. Therefore, development of prevention strategies against RSV for all infants entering their first RSV season constitutes a large unmet medical need. The aim of this review is to explore different immunization approaches to protect all infants against RSV. Prevention strategies include maternal immunization, immunization of infants with vaccines, immunization of infants with licensed mAbs (palivizumab), and immunization of infants with long-acting mAbs (e.g., nirsevimab, MK-1654). Of these, palivizumab use is restricted to a small population of infants and does not offer a solution for all-infant protection, whereas vaccine development in infants has encountered various challenges, including the immaturity of the infant immune system, highlighting that future pediatric vaccines will most likely be used in older infants (>6 months of age) and children. Consequently, maternal immunization and immunization of infants with long-acting mAbs represent the two feasible strategies for protection of all infants against RSV. Here, we present considerations regarding these two strategies covering key areas which include mechanism of action, "consistency" of protection, RSV variability, duration of protection, flexibility and optimal timing of immunization, benefit for the mother, programmatic implementation, and acceptance of each strategy by key stakeholders. We conclude that, based on current data, immunization of infants with long-acting mAbs might represent the most effective approach for protecting all infants entering their first RSV season.
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Affiliation(s)
- Susanna Esposito
- Pediatric Clinic, Pietro Barilla Children’s Hospital, University of Parma, Parma, Italy
| | - Bahaa Abu Raya
- Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Eugenio Baraldi
- Neonatal Intensive Care Unit, Department of Woman’s and Child’s Health, Padova University Hospital, Padova, Italy
| | - Katie Flanagan
- School of Medicine, Faculty of Health Sciences, University of Tasmania, Launceston, TAS, Australia
- School of Health and Biomedical Science, RMIT University, Melbourne, VIC, Australia
- Department of Immunology and Pathology, Monash University, Melbourne, VIC, Australia
- Tasmanian Vaccine Trial Centre, Clifford Craig Foundation, Launceston General Hospital, Launceston, TAS, Australia
| | - Federico Martinon Torres
- Genetics, Vaccines, Infections and Pediatrics Research group (GENVIP), Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Maria Tsolia
- Second Department of Pediatrics, National and Kapodistrian University of Athens, “A&P Kyriakou” Children’s Hospital, Athens, Greece
| | - Stefan Zielen
- Department for Children and Adolescents, Division of Allergology, Pulmonology and Cystic Fibrosis, Goethe-University Hospital, Frankfurt am Main, Germany
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10
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Preventing severe influenza in Australian infants: Maternal influenza vaccine effectiveness in the PAEDS-FluCAN networks using the test-negative design. Vaccine 2022; 40:2761-2771. [DOI: 10.1016/j.vaccine.2022.03.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 11/04/2021] [Accepted: 03/17/2022] [Indexed: 11/19/2022]
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11
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Whyler NCA, Kong KL, Krishnaswamy S, Giles M. Attitudes toward year‐round influenza vaccination in pregnant women. Aust N Z J Obstet Gynaecol 2022; 62:323-327. [DOI: 10.1111/ajo.13485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 01/10/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | - Khai Lin Kong
- Monash Infectious Diseases Monash Health Melbourne VictoriaAustralia
| | - Sushena Krishnaswamy
- Monash Infectious Diseases Monash Health Melbourne VictoriaAustralia
- Department of Obstetrics & Gynaecology Monash University Melbourne Victoria Australia
| | - Michelle Giles
- Department of Obstetrics & Gynaecology Monash University Melbourne Victoria Australia
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12
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Cappozzo F, Dal Zotto A, Scollo M, Bernardini D, Maria Dal Zotto A, Bonvecchio L, Tognetto G, Marinangeli S, Negrello C, Lanza P, Cocco A, Falivene P, Vianello L, Di Caprio A, Gabutti G, Saugo M. dTap vaccination uptake during pregnancy: Pregnant women-focused and health professionals-focused predictors in the Veneto Region (Italy). Vaccine 2021; 39:6913-6919. [PMID: 34711438 DOI: 10.1016/j.vaccine.2021.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 09/08/2021] [Accepted: 10/07/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Despite recommendations, the uptake of dTap maternal vaccination is still low in many countries. The reasons for this must be investigated both on the patient's and the healthcare professionals' sides. METHODS A record linkage study was performed linking Birth Assitance Certificates and dTap mothers' vaccination records (5183 deliveries) to describe the influence of socioeconomical and obstetrical-gynecological factors after the recommendations concerning dTap vaccination in pregnancy issued by the Italian Ministry of Health (August 2018). An interview was also administered to a subgroup of 656 new mothers on the occasion of the first vaccination of their newborns, in order to assess the dTap vaccination advice received from maternal care providers during pregnancy. A generalized linear model (binomial family, log link) was implemented to give a correct estimate of the mother's relative risk of being vaccinated. RESULTS Several pregnant women-focused factors are evident, but the most important ones are related to maternal care providers' practices: after mutual adjustment, the explicit advice towards dTap maternal vaccination given by the Obstetrician-Gynecologist or the Midwife is associated with a 12-fold increase in the dTap coverage. CONCLUSIONS Multiprofessional training is essential to make Obstetricians-Gynecologists and Midwives more confident in recommending dTaP maternal immunization.
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Affiliation(s)
- Francesco Cappozzo
- Obstetric and Gynecology Department, Local Health Unit 7, Bassano del Grappa, Italy
| | | | - Marcello Scollo
- Obstetric and Gynecology Department, Local Health Unit 7, Bassano del Grappa, Italy
| | - Daniele Bernardini
- Department of Prevention, Local Health Unit 7, Bassano del Grappa, Italy
| | | | - Lucia Bonvecchio
- Department of Prevention, Local Health Unit 7, Bassano del Grappa, Italy
| | - Gabriella Tognetto
- Department of Prevention, Local Health Unit 7, Bassano del Grappa, Italy
| | | | - Chiara Negrello
- Family Counseling Center, Local Health Unit 7, Bassano del Grappa, Italy
| | - Paola Lanza
- Obstetric and Gynecology Department, Local Health Unit 7, Bassano del Grappa, Italy
| | - Andrea Cocco
- Obstetric and Gynecology Department, Local Health Unit 7, Bassano del Grappa, Italy
| | - Patrizia Falivene
- Department of Prevention, Local Health Unit 7, Bassano del Grappa, Italy
| | - Liviano Vianello
- Department of Prevention, Local Health Unit 7, Bassano del Grappa, Italy
| | - Antonio Di Caprio
- Health Services Director, Local Health Unit 7, Bassano del Grappa, Italy
| | - Giovanni Gabutti
- Department of Medical Sciences,University of Ferrara, Ferrara, Italy
| | - Mario Saugo
- Department of Prevention, Local Health Unit 7, Bassano del Grappa, Italy.
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Attitudes and Communication Preferences for Vaccines among Pregnant Women Receiving Care at a Safety-net Hospital. Womens Health Issues 2021; 32:67-73. [PMID: 34635378 DOI: 10.1016/j.whi.2021.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 09/01/2021] [Accepted: 09/15/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE We aimed to understand pregnant women's perceptions of vaccination during pregnancy and to assess their reaction to different vaccine messages. STUDY DESIGN English-speaking pregnant women aged 18 years or older who received prenatal care at a safety-net hospital participated in qualitative interviews. Interview topics included attitudes toward vaccinations in general and toward influenza and tetanus-diphtheria-pertussis vaccination in pregnancy. Participants were also queried regarding sources of vaccine information, and were asked to provide feedback on specific messages regarding maternal vaccination. RESULTS Twenty-eight pregnant women participated in interviews. Participant age ranged from 18 to 40 years old; 64% were insured through Medicaid. All participants had positive attitudes toward routine vaccinations and had received vaccinations for themselves and their children. Attitudes were less favorable for influenza vaccines than other vaccines. Participants reported receiving vaccine information from multiple sources. Stories about vaccine harms worried participants, even when they did not trust the sources of negative information. All stated that their health care providers were the most trusted source of information. Participants felt that the most important messages to encourage maternal vaccination were that maternal vaccination protects the baby after birth and maternal vaccination is safe for both mother and baby. Participants were not motivated to vaccinate by messages about the severity of maternal disease. CONCLUSIONS Maternal vaccinations are important to protect pregnant women and infants from influenza and pertussis. Focusing on messages related to vaccine safety and protection of the infant are motivating to mothers, especially when delivered by trusted health care providers.
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Bonito B, Balzi D, Boccalini S, Bonanni P, Mereu G, Santini MG, Bechini A. Descriptive Observational Study of Tdap Vaccination Adhesion in Pregnant Women in the Florentine Area (Tuscany, Italy) in 2019 and 2020. Vaccines (Basel) 2021; 9:vaccines9090955. [PMID: 34579192 PMCID: PMC8473358 DOI: 10.3390/vaccines9090955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/23/2021] [Accepted: 08/24/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Tdap (Tetanus-Diphtheria-acellular Pertussis) vaccination is nowadays a worldwide-recommended practice to immunize pregnant women. The vaccine administration at the third trimester of pregnancy (as recommended by the WHO) would ensure antibody protection to both the mother and the newborn and has contributed to the significant drop of pertussis cases in infants. The aim of this observational study was to describe for the first time the socio-demographic characteristics and determinants of Tdap vaccination adhesion of pregnant women in the Florentine area. Methods: Information about parents’ vaccination status, their citizenship, employment type and mothers’ previous pregnancies and/or abortions were collected at the time of birth through the assistance birth certificates (CedAP) both for the years 2019 and 2020. This archive and the regional SISPC (Collective Prevention Healthcare Information System) linked using an anonymous unique personal identifier to retrieve the mother’s vaccination status. Results: We found an overall Tdap vaccination adhesion of 43% in 2019 and 47.3% in 2020. Several socio-demographic parameters would determine an increased vaccination adhesion, including parents’ geographical origin, mothers’ age and educational background, as well as the number of previous deliveries, abortions or voluntary termination of pregnancy. Conclusions: Since not much data are available on this topic in Italy, this study may constitute the baseline information for Tdap vaccination adhesion in pregnant women in the Florentine area (Italy). Thus, future successful vaccination strategies may be designed accordingly.
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Affiliation(s)
- Benedetta Bonito
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.B.); (S.B.); (P.B.)
| | - Daniela Balzi
- AUSL Toscana Centro, 50122 Florence, Italy; (D.B.); (G.M.); (M.G.S.)
| | - Sara Boccalini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.B.); (S.B.); (P.B.)
| | - Paolo Bonanni
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.B.); (S.B.); (P.B.)
| | - Giovanna Mereu
- AUSL Toscana Centro, 50122 Florence, Italy; (D.B.); (G.M.); (M.G.S.)
| | | | - Angela Bechini
- Department of Health Sciences, University of Florence, 50134 Florence, Italy; (B.B.); (S.B.); (P.B.)
- Correspondence: ; Tel.: +39-055-2751-081
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15
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Tang X, Tang T, Yan R, Zhou Y, Deng X, He H. Intention to accept pertussis vaccination among Chinese people older than age 5. Hum Vaccin Immunother 2021; 17:1686-1692. [PMID: 33449818 DOI: 10.1080/21645515.2020.1849517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Background: The intention of Chinese people older than age 5 to accept the pertussis vaccination is unknown, which is important for the future design of an effective pertussis vaccination program in China.Method: We conducted a cross-sectional survey among people older than age 5 in China. A 24-item questionnaire was used to explore the determinants of intention to accept a pertussis vaccination, and for children and adolescents (≦15 years old), their guardian was required to help answer the questionnaire on their behalf. Univariate and multivariate logistic regression was used to analyze the influencing factors of intention.Results: A total of 3,041 individuals participated in our survey and 3025 completed the questionnaire, among which 1938 (64.07%) reported a positive intention to be vaccinated. A multiple logistic regression analysis revealed that the main positive factors for the intention to accept pertussis vaccination were younger age (Odd ratio [OR] 0.838, P < .001), higher educational attainment (OR 1.171, P = .002), no hospitalization because of the most recent cough (OR 2.468, P < .001), awareness about pertussis (OR 1.958, P < .001), and consideration of pertussis vaccination to be safe (OR 1.450, P = .026).Conclusion: There is a relatively high level of intention to receive the pertussis vaccine among people older than age 5 in China. Future pertussis vaccination strategies geared at them should consider focusing on middle-aged and older individuals and those with a low education as well as strengthen the promotion of disease characteristics, vaccine effectiveness, and safety.
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Affiliation(s)
- Xuewen Tang
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, P.R. China
| | - Tingting Tang
- Department of Immunization Program, Yunnan Provincial Center for Disease Control and Prevention, Kunming, P.R. China
| | - Rui Yan
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, P.R. China
| | - Yang Zhou
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, P.R. China
| | - Xuan Deng
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, P.R. China
| | - Hanqing He
- Department of Immunization Program, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, P.R. China
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Qiu X, Bailey H, Thorne C. Barriers and Facilitators Associated With Vaccine Acceptance and Uptake Among Pregnant Women in High Income Countries: A Mini-Review. Front Immunol 2021; 12:626717. [PMID: 33981298 PMCID: PMC8107947 DOI: 10.3389/fimmu.2021.626717] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 03/29/2021] [Indexed: 01/09/2023] Open
Abstract
Vaccination during pregnancy is a safe and effective intervention to protect women from potentially severe consequences of influenza and reduce risk of influenza and pertussis in their infants. However, coverage remains variable. In this mini-review we update findings from a 2015 systematic review to describe results from recent studies in high income countries on the uptake of influenza and pertussis vaccination in pregnancy, reasons for vaccine hesitancy and barriers to increasing uptake, from maternal and healthcare provider (HCP) perspectives. Studies reported highly variable uptake (from 0% to 78%). A main facilitator for uptake among pregnant women was receiving a recommendation from their HCP. However, studies showed that HCP awareness of guidelines did not consistently translate into them recommending vaccines to pregnant women. Safety concerns are a well-established barrier to uptake/coverage of maternal immunization; 7%-52% of unvaccinated women gave safety concerns as a reason but these were also present in vaccinated women. Knowledge/awareness gaps among pregnant women and lack of confidence among HCPs to discuss vaccination were both important barriers. Several studies indicated that midwives were more likely to express safety concerns than other HCPs, and less likely to recommend vaccination to pregnant women. Women who perceived the risk of infection to be low were less likely to accept vaccination in several studies, along with women with prior vaccine refusal. Findings highlight the importance of further research to explore context-specific barriers to vaccination in pregnancy, which may include lack of vaccine confidence among pregnant woman and HCPs, and policy and structural factors.
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Affiliation(s)
- Xiao Qiu
- UCL Institute for Global Health, University College London, London, United Kingdom
| | - Heather Bailey
- UCL Institute for Global Health, University College London, London, United Kingdom
| | - Claire Thorne
- UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom
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Giduthuri JG, Purohit V, Kudale A, Utzinger J, Schindler C, Weiss MG. Antenatal influenza vaccination in urban Pune, India: clinician and community stakeholders' awareness, priorities, and practices. Hum Vaccin Immunother 2021; 17:1211-1222. [PMID: 32966146 PMCID: PMC8018408 DOI: 10.1080/21645515.2020.1806670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 08/01/2020] [Indexed: 12/14/2022] Open
Abstract
The World Health Organization (WHO) recommends antenatal influenza vaccination (AIV) for pregnant women at any stage of pregnancy. This study assessed fundamental aspects of AIV acceptance and demand among key stakeholders in urban Pune, India. Semi-structured interviews for rapid ethnographic assessment of AIV-related awareness, priorities, and practices were used to study clinicians and their communities of practice. A qualitative survey was conducted among 16 private clinicians providing antenatal care (ANC) in slum and middle-class areas of Pune. Following the survey, clinicians were informed about authoritative AIV recommendations. A qualitative community survey was also conducted with 60 women aged 20-35 years and 30 spouses from the same slum and middle-class practice areas of the ANC providers. Subsequently, a second clinician survey was conducted to assess changes in clinicians' awareness, priority, and vaccination practice. After this interview, clinicians were informed of community survey findings. Most community respondents were unaware of AIV, in contrast with well-known and widely used antenatal tetanus vaccination. They expressed confidence in vaccines and trust in the clinicians. Clinicians' advice was reportedly the most important determinant of community vaccine acceptance. Clinicians were confident of the safety of AIV and they anticipated patients' acceptance if recommended. The second clinician interview showed increased awareness of AIV policy, but clinicians were more skeptical about the severity of maternal influenza in their practice. Our findings indicate community acceptance though not demand for AIV. We recommend five essential elements for vaccination program strategies to improve coverage with AIV and other ANC vaccines.
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Affiliation(s)
- Joseph G. Giduthuri
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Vidula Purohit
- The Maharashtra Association of Anthropological Sciences, Centre for Health Research and Development, Pune, India
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
| | - Abhay Kudale
- The Maharashtra Association of Anthropological Sciences, Centre for Health Research and Development, Pune, India
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Mitchell G. Weiss
- Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Castillo E, Patey A, MacDonald N. Vaccination in pregnancy: Challenges and evidence-based solutions. Best Pract Res Clin Obstet Gynaecol 2021; 76:83-95. [PMID: 34090801 DOI: 10.1016/j.bpobgyn.2021.03.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 03/09/2021] [Indexed: 01/31/2023]
Abstract
Vaccination in pregnancy (VIP) is dually beneficial - it protects the mother and the baby from tetanus, influenza, and pertussis. VIP uptake is low in many countries. Vaccine hesitancy, defined by the World Health Organization (WHO) as a "delay in acceptance or refusal of vaccination despite the availability of vaccination services" is one of WHO's ten threats to global health per 2019. According to extensive research, mostly from high-income countries (HIC) and limited to tetanus, influenza and pertussis vaccines, lack of provider recommendations, safety concerns, and limitations in access are the main barriers to VIP. Health care provider recommendation is the leading facilitator for VIP across various socioeconomic status groups. Data on strategies to overcome patient, provider, and system barriers to VIP are inconsistent, contradictory, or lacking. Patient-focused research on evidence-based strategies to overcome provider and system barriers is needed. Furthermore, VIP programs require embedded continuous quality improvement to ensure sustainability.
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Affiliation(s)
- Eliana Castillo
- Department of Medicine, University of Calgary, Canada; Department of Obstetrics and Gynaecology University of Calgary, Canada.
| | - Andrea Patey
- Centre for Implementation Research, Ottawa Hospital Research Institute, Canada; Faculty of Health Sciences, Queen's University, Canada
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Definitions of Culturally and Linguistically Diverse (CALD): A Literature Review of Epidemiological Research in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020737. [PMID: 33467144 PMCID: PMC7830035 DOI: 10.3390/ijerph18020737] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/10/2021] [Accepted: 01/11/2021] [Indexed: 01/04/2023]
Abstract
Objective: To identify how Culturally and Linguistically Diverse (CALD) communities are defined in epidemiological research in Australia and provide a definition of CALD status that aids the consistency and interpretability of epidemiological studies. Methods: Peer-reviewed literature from January 2015 to May 2020 was searched via four databases (Ovid Medline combined with PubMed, Embase, Emcare, and CINAHL) to identify quantitative studies of CALD people in Australia. Results: A total of 108 studies met the criteria for inclusion in the review. Country of birth was the most commonly used CALD definition (n = 33, 30.6%), with combinations of two or more components also frequently used (n = 31, 28.7%). No studies used all the components suggested as core to defining CALD status. including country of birth, languages other than English spoken at home, English proficiency, and indigenous status. Conclusions: There was considerable inconsistency in how CALD status was defined. The review suggests that CALD status would best be defined as people born in non-English speaking countries, and/or who do not speak English at home. Additionally, indigenous peoples should be considered separately. This recommended definition will support the better identification of potential health disparity and needs in CALD and indigenous communities.
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Martin S, Kilich E, Dada S, Kummervold PE, Denny C, Paterson P, Larson HJ. "Vaccines for pregnant women…?! Absurd" - Mapping maternal vaccination discourse and stance on social media over six months. Vaccine 2020; 38:6627-6637. [PMID: 32788136 DOI: 10.1016/j.vaccine.2020.07.072] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 07/24/2020] [Accepted: 07/31/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To understand the predominant topics of discussion, stance and associated language used on social media platforms relating to maternal vaccines in 15 countries over a six-month period. BACKGROUND In 2019, the World Health Organisation prioritised vaccine hesitancy as a top ten global health threat and recognized the role of viral misinformation on social media as propagating vaccine hesitancy. Maternal vaccination offers the potential to improve maternal and child health, and to reduce the risk of severe morbidity and mortality in pregnancy. Understanding the topics of discussion, stance and language used around maternal vaccines on social media can inform public health bodies on how to combat vaccine misinformation and vaccine hesitancy. METHODS Social media data was extracted (Twitter, forums, blogs and comments) for six months from 15 countries (Australia, Brazil, Canada, France, Germany, India, Italy, Korea, Mexico, Panama, South Africa, Spain, United Kingdom and United States). We used stance, discourse and topic analysis to provide insight into the most frequent and weighted keywords, hashtags and themes of conversation within and across countries. RESULTS We exported a total of 19,192 social media posts in 16 languages obtained between 1st November 2018 and 30th April 2019. After screening all posts, 16,000 were included in analyses, while excluding retweets, 2,722 were annotated for sentiment. Main topics of discussion were the safety of the maternal influenza and pertussis vaccines. Discouraging posts were most common in Italy (44.9%), and the USA (30.8%). CONCLUSION The content and stance of maternal vaccination posts from November 2018 to April 2019 differed across countries, however specific topics of discussion were not limited to geographical location. These discussions included the promotion of vaccination, involvement of pregnant women in vaccine research, and the trust and transparency of institutions. Future research should examine the relationship between stance (promotional, neutral, ambiguous, discouraging) online and maternal vaccination uptake in the respective regions.
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Affiliation(s)
- Sam Martin
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK.
| | - Eliz Kilich
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Sara Dada
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | | | - Chermain Denny
- Faculty of Science, Vrije University, Amsterdam, Netherlands
| | - Pauline Paterson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | - Heidi J Larson
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK; Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
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Kilich E, Dada S, Francis MR, Tazare J, Chico RM, Paterson P, Larson HJ. Factors that influence vaccination decision-making among pregnant women: A systematic review and meta-analysis. PLoS One 2020; 15:e0234827. [PMID: 32645112 PMCID: PMC7347125 DOI: 10.1371/journal.pone.0234827] [Citation(s) in RCA: 103] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 06/02/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The most important factor influencing maternal vaccination uptake is healthcare professional (HCP) recommendation. However, where data are available, one-third of pregnant women remain unvaccinated despite receiving a recommendation. Therefore, it is essential to understand the significance of other factors and distinguish between vaccines administered routinely and during outbreaks. This is the first systematic review and meta-analysis (PROSPERO: CRD 42019118299) to examine the strength of the relationships between identified factors and maternal vaccination uptake. METHODS We searched MEDLINE, Embase Classic & Embase, PsycINFO, CINAHL Plus, Web of Science, IBSS, LILACS, AfricaWideInfo, IMEMR, and Global Health databases for studies reporting factors that influence maternal vaccination. We used random-effects models to calculate pooled odds ratios (OR) of being vaccinated by vaccine type. FINDINGS We screened 17,236 articles and identified 120 studies from 30 countries for inclusion. Of these, 49 studies were eligible for meta-analysis. The odds of receiving a pertussis or influenza vaccination were ten to twelve-times higher among pregnant women who received a recommendation from HCPs. During the 2009 influenza pandemic an HCP recommendation increased the odds of antenatal H1N1 vaccine uptake six times (OR 6.76, 95% CI 3.12-14.64, I2 = 92.00%). Believing there was potential for vaccine-induced harm had a negative influence on seasonal (OR 0.22, 95% CI 0.11-0.44 I2 = 84.00%) and pandemic influenza vaccine uptake (OR 0.16, 95% CI 0.09-0.29, I2 = 89.48%), reducing the odds of being vaccinated five-fold. Combined with our qualitative analysis the relationship between the belief in substantial disease risk and maternal seasonal and pandemic influenza vaccination uptake was limited. CONCLUSIONS The effect of an HCP recommendation during an outbreak, whilst still powerful, may be muted by other factors. This requires further research, particularly when vaccines are novel. Public health campaigns which centre on the protectiveness and safety of a maternal vaccine rather than disease threat alone may prove beneficial.
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Affiliation(s)
- Eliz Kilich
- Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, London, United Kingdom
| | - Sara Dada
- Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, London, United Kingdom
| | - Mark R. Francis
- Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, London, United Kingdom
| | - John Tazare
- Department of Medical Statistics, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, London, United Kingdom
| | - R. Matthew Chico
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Topical Medicine, London, United Kingdom
| | - Pauline Paterson
- Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, London, United Kingdom
| | - Heidi J. Larson
- Department of Infectious Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Topical Medicine, London, United Kingdom
- Institute of Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America
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Kong KL, Chu S, Giles ML. Factors influencing the uptake of influenza vaccine vary among different groups in the hard‐to‐reach population. Aust N Z J Public Health 2020; 44:163-168. [DOI: 10.1111/1753-6405.12964] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 08/01/2019] [Accepted: 11/01/2019] [Indexed: 11/26/2022] Open
Affiliation(s)
- Khai Lin Kong
- Department of Obstetrics and GynaecologyMonash University Melbourne Victoria
| | - Sandy Chu
- Faculty of Medicine, Nursing and Health SciencesMonash University Melbourne Victoria
| | - Michelle L. Giles
- Department of Obstetrics and GynaecologyMonash University Melbourne Victoria
- Monash Immunisation, Monash Health Melbourne Victoria
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Moir D, Gunter K, Lynch LA, Vogrin S, Said J. Antenatal vaccine uptake: A cross-sectional study investigating factors influencing women's choices in pregnancy. Aust N Z J Obstet Gynaecol 2020; 60:729-737. [PMID: 32207153 DOI: 10.1111/ajo.13146] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 02/04/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND Seasonal influenza and pertussis cause significant morbidity and mortality among expectant mothers and infants. Vaccination during the antenatal period is an important public health intervention, minimising rates of maternal, neonatal and infant infection. AIMS The primary aim of this project was to establish the rates of antenatal vaccine uptake. Secondly, the study aimed to determine socio-demographic factors significant to vaccine uptake. Thirdly, the project aimed to produce a thematic analysis of the factors affecting vaccination uptake during pregnancy. MATERIALS AND METHODS A cross-sectional observational study was conducted among women attending a large maternity hospital, in the western suburbs of Melbourne, for perinatal care. Data were collected via self-completed questionnaires after delivery. Data from the questionnaires were entered into an electronic database, and STATA was used to undertake correlation analysis. RESULTS Over a 12-month period 1678 women completed questionnaires and 1305 were eligible for further analysis. The uptake of influenza vaccine was 48.3%, pertussis vaccine uptake was higher, at 82.9%. Uptake of influenza and pertussis vaccines strongly correlated with recommendations from healthcare providers (odds ratios 29.7 and 63.8 respectively). Maternal country of birth, age and parity were significant predictors of vaccine uptake. In thematic analysis, healthcare provider recommendation and the perceived risk of the disease were factors resulting in vaccination. CONCLUSION This study determined the rate of antenatal vaccine uptake and significant socio-demographic determinants affecting uptake at a large maternity hospital in metropolitan Melbourne. Ensuring healthcare providers recommend vaccination is likely to improve coverage.
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Affiliation(s)
- Drew Moir
- Department of Obstetrics and Gynaecology, Western Health, Melbourne, Victoria, Australia
| | - Konrad Gunter
- Department of Obstetrics and Gynaecology, Western Health, Melbourne, Victoria, Australia
| | - Lee-Anne Lynch
- Maternal Fetal Medicine Department, Western Health, Melbourne, Victoria, Australia
| | - Sara Vogrin
- Melbourne Medical School, Western Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Joanne Said
- Maternal Fetal Medicine Department, Western Health, Melbourne, Victoria, Australia
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Yakut N, Soysal S, Soysal A, Bakir M. Knowledge and acceptance of influenza and pertussis vaccinations among pregnant women of low socioeconomic status in Turkey. Hum Vaccin Immunother 2019; 16:1101-1108. [PMID: 31687874 DOI: 10.1080/21645515.2019.1689082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Pregnant women and infants are at relatively high risk for influenza- and pertussis-related morbidity and mortality. Vaccination is the most important prevention strategy for both diseases. We evaluated knowledge and acceptance of influenza and pertussis vaccinations among pregnant women. We performed a cross-sectional survey of 465 pregnant women receiving prenatal care at the obstetric outpatient clinic in a tertiary medical center in Turkey between November 2015 and May 2016. We used a questionnaire investigating the knowledge of pertussis and influenza to evaluate potential influences on the acceptance or rejection of pertussis or influenza vaccinations. The acceptance rates of pertussis and influenza vaccinations were 11.2% and 19.8%, respectively. Maternal age, education level, employment status, number of gestations, and gestational age did not affect the rate of acceptance of these vaccinations. On the other hand, pregnant women who had a history of vaccination during their adolescence and in previous pregnancies were significantly more likely to accept pertussis vaccination. Knowledge about the risks of pertussis and influenza diseases for pregnant women and their children has a significant effect on vaccination acceptance. Even in low socioeconomic status groups, a recommendation for vaccinations by the primary obstetrician was significantly predictive of acceptance of both pertussis and influenza vaccination. This study revealed that the acceptance rates of pertussis and influenza vaccination among pregnant women are very low in Turkey. Healthcare worker recommendations and increased awareness about pertussis and influenza morbidity and mortality in pregnant women and infants are essential to improve the rates of vaccination acceptance during pregnancy.
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Affiliation(s)
- Nurhayat Yakut
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University Medical Faculty, Istanbul, Turkey
| | - Sunullah Soysal
- Department of Obstetrics and Gynecology, Marmara University Medical Faculty, Istanbul, Turkey
| | - Ahmet Soysal
- Clinics of Pediatrics, Atasehir Memorial Hospital, Istanbul, Turkey
| | - Mustafa Bakir
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Marmara University Medical Faculty, Istanbul, Turkey
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Giles ML, Buttery J, Davey MA, Wallace E. Pregnant women's knowledge and attitude to maternal vaccination including group B streptococcus and respiratory syncytial virus vaccines. Vaccine 2019; 37:6743-6749. [PMID: 31540809 DOI: 10.1016/j.vaccine.2019.08.084] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 08/11/2019] [Accepted: 08/30/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND Maternal immunisation is an important strategy to reduce neonatal mortality and morbidity. New maternal vaccines such as Respiratory Syncytial Virus (RSV) and Group B streptococcus (GBS) are in development and/or clinical trials. However, little is known about pregnant women's knowledge about these diseases. METHODS Women attending antenatal clinics in Melbourne, Australia were invited to complete a questionnaire collecting demographic information, past vaccination history, understanding of risk of GBS and RSV disease in pregnancy and likelihood to accept these theoretical vaccines in the future. FINDINGS 495 women (48% born outside of Australia, from 48 different countries) completed the questionnaire. A large number of women had never heard of GBS (63%) or RSV (83%). Women over 35 years, born in Australia and women who had more than one child were more likely to have heard of GBS or RSV (p < 0.001). Women who had received influenza or pertussis vaccine in pregnancy were more likely to accept a RSV or GBS vaccine (p < 0.001). CONCLUSIONS This study has shown that knowledge of GBS and RSV is poor. However, when provided with information about the two diseases, acceptance of a hypothetical vaccine for both diseases was high. This study highlights the enormous amount of work that needs to be done in educating pregnant women about the seriousness of these two diseases if a future vaccine is ever to be accepted and high coverage achieved among the target population.
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Affiliation(s)
- Michelle L Giles
- The Ritchie Centre, Department of Obstetrics and Gynaecology, Monash University, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia; Women's and Children's Health, Monash Health, 246 Clayton Road, Clayton, Victoria 3168, Australia; Monash Immunisation, Monash Health, 246 Clayton Road, Clayton, Victoria 3168, Australia.
| | - Jim Buttery
- School of Public Health and Preventive Medicine and Department of Pediatrics, Monash University, 246 Clayton Road, Clayton, Victoria 3168, Australia; Monash Immunisation, Monash Health, 246 Clayton Road, Clayton, Victoria 3168, Australia
| | - Mary-Ann Davey
- The Ritchie Centre, Department of Obstetrics and Gynaecology, Monash University, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
| | - Euan Wallace
- The Ritchie Centre, Department of Obstetrics and Gynaecology, Monash University, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
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Chang Y, Tsai S, Lin P, Chou F. Willingness to receive influenza vaccination during pregnancy and associated factors among pregnant women in Taiwan. Public Health Nurs 2019; 36:284-295. [DOI: 10.1111/phn.12600] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 01/05/2019] [Accepted: 02/03/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Ya‐Wen Chang
- College of Nursing Kaohsiung Medical University Kaohsiung City Taiwan, R.O.C
- Department of Nursing National Tainan Institute of Nursing Tainan City Taiwan, R.O.C
| | - Shiow‐Meei Tsai
- Department of Nursing National Tainan Institute of Nursing Tainan City Taiwan, R.O.C
| | - Pao‐Chen Lin
- Department of Nursing National Tainan Institute of Nursing Tainan City Taiwan, R.O.C
| | - Fan‐Hao Chou
- College of Nursing Kaohsiung Medical University Kaohsiung City Taiwan, R.O.C
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Heywood AE, López-Vélez R. Reducing infectious disease inequities among migrants. J Travel Med 2019; 26:5198602. [PMID: 30476162 DOI: 10.1093/jtm/tay131] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 11/13/2018] [Accepted: 11/20/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND migration has reached unprecedented levels, with 3.6% of the world's population living outside their country of birth. Migrants comprise a substantial proportion of high-income country populations, are at increased risk of a range of infectious diseases, compared to native-born populations and may experience worse health outcomes due to barriers accessing timely diagnoses and treatment. Poor access to essential healthcare services can be attributed to several factors, including language and cultural barriers and lack of specific inclusive health policies. METHODS This review draws on evidence from the immigrant health and travel medicine literature, with a focus on infectious disease risks. It presents strategies to reduce barriers to healthcare access through health promotion and screening programs both at the community and clinic level and the delivery of linguistically and culturally competent care. The Methods: Salud Entre Culturas (SEC) 'Health Between Cultures' project from the Tropical Medicine Unit at the Hospital Ramon y Cajal in Madrid is described as an effective model of care. RESULTS For those providing healthcare to migrant populations, the use of community-consulted approaches are considered best practice in the development of health education, health promotion and the delivery of targeted health services. At the clinic-level, strategies optimizing care for migrants include the use of bilingual healthcare professionals or community-based healthcare workers, cultural competence training of all clinic staff, the appropriate use of trained interpreters and the use of culturally appropriate health promotion materials. CONCLUSIONS Multifaceted strategies are needed to improve access, community knowledge, community engagement and healthcare provider training to provide appropriate care to migrant populations to reduce infectious disease disparities.
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Affiliation(s)
- Anita E Heywood
- Level 3, Samuels Building, School of Public Health and Community Medicine, UNSW Sydney, NSW, Australia
| | - Rogelio López-Vélez
- National Referral Unit for Tropical Diseases, Department of Infectious Diseases, Ramón y Cajal University Hospital, Madrid, Spain
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Krishnaswamy S, Lambach P, Giles ML. Key considerations for successful implementation of maternal immunization programs in low and middle income countries. Hum Vaccin Immunother 2019; 15:942-950. [PMID: 30676250 PMCID: PMC6605837 DOI: 10.1080/21645515.2018.1564433] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 12/05/2018] [Accepted: 12/17/2018] [Indexed: 12/12/2022] Open
Abstract
The Maternal Neonatal Tetanus Elimination program is proof of concept for the feasibility and potential for maternal immunization to reduce neonatal mortality particularly in low and middle-income countries. Introduction of any additional vaccine into the antenatal space, such as Influenza and Pertussis, and potentially Respiratory Syncytial Virus and Group B Streptococcus vaccines in the future, requires strengthening of antenatal care and immunization services. Successful implementation also requires robust disease surveillance in pregnant women and neonates and active surveillance for adverse events following immunization to monitor the impact and ensure the safe use of the vaccine. This review outlines five key elements essential for successful implementation of a maternal immunization program focusing particularly on low and middle-income countries. These include; relevant considerations in supporting a decision to undertake a maternal immunization program including knowledge of local disease epidemiology, involvement of the consumer, healthcare provider recommendation, equitable access to maternal vaccination, and systems for disease surveillance, program evaluation and safety monitoring.
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Affiliation(s)
- Sushena Krishnaswamy
- The Ritchie Centre, Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia
| | - Philipp Lambach
- Initiative for Vaccine Research, World Health Organization, Geneva, Switzerland
| | - Michelle L. Giles
- The Ritchie Centre, Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia
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Mak DB, Regan AK, Vo DT, Effler PV. Antenatal influenza and pertussis vaccination in Western Australia: a cross-sectional survey of vaccine uptake and influencing factors. BMC Pregnancy Childbirth 2018; 18:416. [PMID: 30355329 PMCID: PMC6201540 DOI: 10.1186/s12884-018-2051-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 10/10/2018] [Indexed: 03/04/2023] Open
Abstract
Background Influenza and pertussis vaccines have been recommended in Australia for women during each pregnancy since 2010 and 2015, respectively. Estimating vaccination coverage and identifying factors affecting uptake are important for improving antenatal immunisation services. Methods A random sample of 800 Western Australian women ≥18 years of age who gave birth between 4th April and 4th October 2015 were selected. Of the 454 (57%) who were contactable by telephone, 424 (93%) completed a survey. Data were weighted by maternal age and area of residence to ensure representativeness. The proportion immunised against influenza and pertussis was the main outcome measure; multivariate logistic regression was used to identify factors significantly associated with antenatal vaccination. Results from the 2015 study were compared to similar surveys conducted in 2012–2014. Results In 2015, 71% (95% CI 66–75) of women received pertussis-containing vaccine and 61% (95% CI 56–66) received influenza vaccine during pregnancy; antenatal influenza vaccine coverage was 18% higher than in 2014 (43%; 95% CI: 34–46). Pertussis and influenza vaccine were co-administered for 68% of the women who received both vaccines. The majority of influenza vaccinations in 2015 were administered during the third trimester of pregnancy, instead of the second trimester, as was observed in prior years. Women whose care provider recommended both antenatal vaccinations had significantly higher odds of being vaccinated against both influenza and pertussis (OR 33.3, 95% CI: 15.15–73.38). Of unvaccinated mothers, 53.6% (95% CI: 45.9–61.3) and 78.3% (95% CI: 70.4–85.3) reported that they would have been vaccinated against influenza and pertussis, respectively, if their antenatal care provider had recommended it. Conclusions Pertussis vaccination coverage was high in the first year of an antenatal immunisation program in Western Australia. Despite a substantial increase in influenza vaccination uptake between 2014 and 2015, coverage remained below that for pertussis. Our data suggest influenza and pertussis vaccination rates of 83% and 94%, respectively, are achievable if providers were to recommend them to all pregnant women.
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Affiliation(s)
- Donna B Mak
- Communicable Disease Control Directorate, Department of Health, Shenton Park, Western Australia. .,School of Medicine, University of Notre Dame, Fremantle, Western Australia.
| | - Annette K Regan
- Communicable Disease Control Directorate, Department of Health, Shenton Park, Western Australia.,School of Public Health, Curtin University, Bentley, Western Australia
| | - Dieu T Vo
- Communicable Disease Control Directorate, Department of Health, Shenton Park, Western Australia.,School of Population Health, University of Western Australia, Crawley, Western Australia
| | - Paul V Effler
- Communicable Disease Control Directorate, Department of Health, Shenton Park, Western Australia.,School of Pathology and Laboratory Medicine, University of Western Australia, Crawley, Western Australia
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30
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D'Alessandro A, Napolitano F, D'Ambrosio A, Angelillo IF. Vaccination knowledge and acceptability among pregnant women in Italy. Hum Vaccin Immunother 2018; 14:1573-1579. [PMID: 29863958 PMCID: PMC6067873 DOI: 10.1080/21645515.2018.1483809] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 05/19/2018] [Accepted: 05/24/2018] [Indexed: 01/25/2023] Open
Abstract
The aims of this survey were to ascertain pregnant women's level of knowledge and acceptability on the vaccinations and to identify their associations with several characteristics. A cross-sectional study was performed from December 2017 through March 2018 in the geographic area of Naples, Italy. The study used two stages cluster sampling method for selection and recruitment of participants. Data were collected through face-to-face interviews with pregnant women present at the Obstetrics outpatient clinic of the selected hospitals. A total of 358 respondents agreed to be interviewed out of the 405 pregnant women selected. One-fourth knew at least one of the vaccinations recommended during pregnancy and only 2.8% correctly identified all of these. Women who had received information about the vaccinations during pregnancy from general practitioners or gynecologists or other sources and those with at least one child were more likely to know at least one of the recommended vaccinations, whereas women with middle school education were less knowledgeable. None of the women had received tetanus, diphtheria, and acellular pertussis vaccine and only 1.4% the seasonal influenza vaccination. Only 27.9% reported a positive willingness to receive all the recommended vaccinations during pregnancy. Pregnant women would be willing to get all recommended vaccinations if they had at least one child and if they needed additional information, whereas the willingness was significantly lower among women who had reported high school as the highest level of education, who were in the second trimester of pregnancy, and who felt that the recommended vaccines administered during pregnancy were less dangerous for them and for the unborn child. This study suggests important focus points to be taking into account for informing and for implementing education activities on the benefits regarding vaccinations in order to increase the level of knowledge and the uptake in pregnant women.
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Affiliation(s)
- Alessia D'Alessandro
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, (Italy)
| | - Francesco Napolitano
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, (Italy)
| | - Antonio D'Ambrosio
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, (Italy)
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