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Widdershoven V, Reijs RP, Eskes A, Verhaegh-Haasnoot A, Hoebe CJPA. Maternal pertussis vaccination behavior: Psychosocial, attitudinal and organizational factors. Vaccine 2023; 41:7469-7475. [PMID: 37951791 DOI: 10.1016/j.vaccine.2023.11.013] [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: 05/27/2023] [Revised: 11/03/2023] [Accepted: 11/04/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND In December 2019, the maternal pertussis vaccination (MPV) became part of the Dutch National Immunization Program. This study aims to study MPV behavior and associated psychosocial, attitudinal and organizational factors of pertussis vaccination behavior during pregnancy in the Netherlands. METHODS We conducted a cross-sectional survey among pregnant women and recent mothers, up to six months post-partum. The primary outcome measure of this study was MPV behavior. Associations between psychosocial, attitudinal and organizational factors and MPV behavior were assessed using univariate and multivariate binary logistic regression analysis. RESULTS In total 1348 participants filled out the questionnaire, including 1282 (95.1%) MPV acceptors and 66 (4.9%) MPV refusers. The most important factors associated with MPV behavior were: attitude (aOR: 10.19; 95%CI: 4.30-24.16), outcome expectations (aOR: 8.94; 95%CI: 3.60-22.21), omission bias (aOR: 0.11; 95%CI: 0.02-0.59) and physical accessibility (aOR: 7.44; 95%CI: 3.37-16.46). CONCLUSION Pregnant women make their decision about the MPV primarily based on attitudinal and psychosocial factors, such as outcome expectations and attitude. A combination and variation of different messages, about the advantages (effectiveness) and disadvantages (side effects) of maternal vaccination, can be used in reaching pregnant women with a positive and negative attitude about the MPV. In addition, strategies to increase MPV uptake should not only focus on providing information, but also decrease experienced practical barriers, such as poor physical accessibility, in people that are intended to receive the MPV but are not getting vaccinated.
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Affiliation(s)
- Veja Widdershoven
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands; Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, Public Health Service South Limburg, PO Box 33, 6400 AA Heerlen, the Netherlands.
| | - Rianne P Reijs
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands; Department of Youth Health Care, Living Lab Public Health, Public Health Service South Limburg, Heerlen, the Netherlands
| | - Annika Eskes
- Department of Youth Health Care, Public Health Service Hollands Noorden, Alkmaar, the Netherlands
| | - Amanja Verhaegh-Haasnoot
- Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, Public Health Service South Limburg, PO Box 33, 6400 AA Heerlen, the Netherlands
| | - Christian J P A Hoebe
- Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPHRI), Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands; Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health, Public Health Service South Limburg, PO Box 33, 6400 AA Heerlen, the Netherlands; Department of Medical Microbiology, Infectious Diseases and Infection Prevention, Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre (MUMC+), PO Box 5800, 6202 AZ Maastricht, the Netherlands
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Ayouni I, Amponsah-Dacosta E, Noll S, Kagina BM, Muloiwa R. Interventions to Improve Knowledge, Attitudes, and Uptake of Recommended Vaccines during Pregnancy and Postpartum: A Scoping Review. Vaccines (Basel) 2023; 11:1733. [PMID: 38140138 PMCID: PMC10747157 DOI: 10.3390/vaccines11121733] [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: 09/12/2023] [Revised: 11/02/2023] [Accepted: 11/14/2023] [Indexed: 12/24/2023] Open
Abstract
Tetanus, pertussis, influenza, and COVID-19 vaccines are recommended for the prevention of related morbidity and mortality during pregnancy and postpartum. Despite the established benefits of vaccination for prenatal and postnatal women, maternal vaccination is not universally included in routine antenatal programs, especially in low- and middle-income countries. Furthermore, the uptake of recommended vaccines among pregnant and postpartum women remains below optimum globally. This review aimed to map the evidence on interventions to improve knowledge, attitudes, and uptake of recommended vaccines among pregnant and postpartum women. We conducted a comprehensive and systematic search for relevant literature in PubMed, Scopus, Web of Science, EBSCOhost, and Google Scholar. Overall, 29 studies published between 2010 and 2023 were included in this review. The majority (n = 27) of these studies were from high-income countries. A total of 14 studies focused on the influenza vaccine, 6 on the Tdap vaccine, 8 on both influenza and Tdap vaccines, and only one study on the COVID-19 vaccine. Patient-centered interventions predominated the evidence base (66%), followed by provider-focused (7%), health system-focused (10%), and multilevel interventions (17%). Overall, the effect of these interventions on knowledge, attitudes, and uptake of maternal vaccines was variable.
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Affiliation(s)
- Imen Ayouni
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town 7700, South Africa;
- Vaccines for Africa Initiative, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7935, South Africa; (E.A.-D.); (S.N.); (B.M.K.)
| | - Edina Amponsah-Dacosta
- Vaccines for Africa Initiative, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7935, South Africa; (E.A.-D.); (S.N.); (B.M.K.)
| | - Susanne Noll
- Vaccines for Africa Initiative, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7935, South Africa; (E.A.-D.); (S.N.); (B.M.K.)
| | - Benjamin M. Kagina
- Vaccines for Africa Initiative, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7935, South Africa; (E.A.-D.); (S.N.); (B.M.K.)
| | - Rudzani Muloiwa
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town 7700, South Africa;
- Vaccines for Africa Initiative, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town 7935, South Africa; (E.A.-D.); (S.N.); (B.M.K.)
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