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Fallucca A, Priano W, Carubia A, Ferro P, Pisciotta V, Casuccio A, Restivo V. Effectiveness of Catch-Up Vaccination Interventions Versus Standard or Usual Care Procedures in Increasing Adherence to Recommended Vaccinations Among Different Age Groups: Systematic Review and Meta-Analysis of Randomized Controlled Trials and Before-After Studies. JMIR Public Health Surveill 2024; 10:e52926. [PMID: 39042433 PMCID: PMC11303899 DOI: 10.2196/52926] [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: 09/19/2023] [Revised: 04/16/2024] [Accepted: 04/30/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND To address the global challenge of vaccine hesitancy, the Strategic Advisory Group of Experts on Immunization strongly promotes vaccination reminder and recall interventions. Coupled with the new opportunities presented by scientific advancements, these measures are crucial for successfully immunizing target population groups. OBJECTIVE This systematic review and meta-analysis aims to assess the effectiveness of various interventions in increasing vaccination coverage compared with standard or usual care. The review will cover all vaccinations recommended for different age groups. METHODS In February 2022, 2 databases were consulted, retrieving 1850 studies. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, 79 manuscripts were included after the assessment phase. These comprised 46 trials/randomized controlled trials (RCTs) and 33 before-after studies. A meta-analysis using a random-effects model was performed with STATA software (version 14.1.2). The selected outcome was the risk ratio (RR) of vaccination coverage improvement effectiveness. Additionally, meta-regression analyses were conducted for the included manuscripts. RESULTS The analyses showed an overall efficacy of RR 1.22 (95% CI 1.19-1.26) for RCTs and RR 1.70 (95% CI 1.54-1.87) for before-after studies when considering all interventions cumulatively. Subgroup analyses identified multicomponent interventions (RR 1.58, 95% CI 1.36-1.85) and recall clinical interventions (RR 1.24, 95% CI 1.17-1.32) as the most effective in increasing vaccination coverage for RCTs. By contrast, educational interventions (RR 2.13, 95% CI 1.60-2.83) and multicomponent interventions (RR 1.61, 95% CI 1.43-1.82) achieved the highest increases for before-after studies. Meta-regression analyses indicated that the middle-aged adult population was associated with a higher increase in vaccination coverage (RCT: coefficient 0.54, 95% CI 0.12-0.95; before-after: coefficient 1.27, 95% CI 0.70-1.84). CONCLUSIONS Community, family, and health care-based multidimensional interventions, as well as education-based catch-up strategies, effectively improve vaccination coverage. Therefore, their systematic implementation is highly relevant for targeting undervaccinated population groups. This approach aligns with national vaccination schedules and aims to eliminate or eradicate vaccine-preventable diseases.
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Affiliation(s)
- Alessandra Fallucca
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
| | - Walter Priano
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
| | - Alessandro Carubia
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
| | - Patrizia Ferro
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
| | - Vincenzo Pisciotta
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
| | - Alessandra Casuccio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, Palermo, Italy
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Huang KH, Xie WT, Wang JY, Yeh TF, Tsai TH, Chang YC. Factors Associated With Influenza Vaccination During Pregnancy: A Real-World Evidence-Based Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241229635. [PMID: 38288548 PMCID: PMC10826373 DOI: 10.1177/00469580241229635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 12/07/2023] [Accepted: 01/11/2024] [Indexed: 02/01/2024]
Abstract
Pregnant women are at increased risk of influenza-related complications. However, the rate of influenza vaccination among pregnant women in Taiwan is low. By analyzing real-world data in this study, we investigated the factors associated with influenza vaccination during pregnancy in Taiwan. This study was a cross-sectional study. We collected real-world data from 2 databases in Taiwan: the Birth Certificate Database and the National Health Insurance Research Database. The study population was pregnant between October 2014 and December 2016 in Taiwan. The multivariate logistic regression was performed to identify factors associated with influenza vaccination, including maternal sociodemographics, trimester, comorbidities, and health-care utilization. The vaccination rate of among pregnant women was 8.2%. Factors significantly associated with a high likelihood of influenza vaccination were age between 30 and 34 years (odds ratio [OR]: 1.14; 95% confidence interval [CI]: 1.10-1.19), second trimester (OR: 1.80; 95% CI: 1.75-1.85), income equal to or exceeding NT$ 38 201 (OR: 1.92; 95% CI: 1.86-1.99), hypertension (OR: 1.16; 95% CI: 1.05-1.29), cardiovascular disease (OR: 1.29; 95% CI: 1.17-1.42), autoimmune disease (OR: 1.47; 95% CI: 1.38-1.58), and chronic pulmonary disease (OR: 1.24; 95% CI: 1.18-1.31). A low level of urbanization, at least 1 hospitalization in the previous year, and the presence of pregnancy complications (eg, gestational diabetes, preeclampsia, and placenta previa) were associated with a lower likelihood rate of influenza vaccination. The influenza vaccination rate among pregnant women in Taiwan was low. Age, gestational age, income level, urbanization level, hypertension, cardiovascular disease, autoimmune disease, chronic pulmonary disease, and pregnancy complications may be associated with influenza vaccination among pregnant women.
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Affiliation(s)
- Kuang-Hua Huang
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Wan-Ting Xie
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Jiun-Yi Wang
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Te-Feng Yeh
- Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Tung-Han Tsai
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Yu-Chia Chang
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
- Department of Long Term Care, National Quemoy University, Kinmen County, Taiwan
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Corbeau M, Mulliez A, Chenaf C, Eschalier B, Lesens O, Vorilhon P. Trends of influenza vaccination coverage in pregnant women: a ten-year analysis from a French healthcare database. Sci Rep 2022; 12:7153. [PMID: 35505069 PMCID: PMC9062868 DOI: 10.1038/s41598-022-11308-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/11/2022] [Indexed: 11/09/2022] Open
Abstract
Pregnant women have a high risk of severe influenza, associated with obstetrical complications. The World Health Organization (WHO) has recommended influenza vaccination for all pregnant women since 2012. The vaccination coverage remains low worldwide, and in Europe, due to a lack of proposition from the health care providers, and a high refusal rate from the women. The primary aim of this study was to estimate the influenza vaccination coverage (IVC) in a population of pregnant women in France, and to analyse its evolution from 2009 to 2018. The secondary objective was to describe the vaccinated population and to find determinants associated with the vaccination. This retrospective cohort study is based on the EGB French health care database, a representative sample of the French population containing data from the health insurance system. All pregnant women who delivered medically or spontaneously over the 2009–2018 period were included. In the 2009–2018 period, only 1.2% pregnant women were vaccinated against influenza (n = 875/72,207; 95% CI 1.14–1.30). The IVC slightly increased after the 2012 WHO recommendation, from 0.33 to 1.79% (p < 0.001) but remained extremely low (4.1% in 2018). Women younger than 25 years old had a low coverage (0.6%) whereas women over 35 years old were more likely to get the influenza vaccine (1.7%; OR: 2.82, 95% CI 2.14–3.71). The vaccination behavior was not influenced by multifetal pregnancy or parity, but socio-economically deprived women were less likely to be vaccinated (OR: 0.81, 95% CI: 0.67–0.98). Women with pre-existing medical conditions had an overall higher vaccination rate (2.5%; OR: 2.32, 95% CI: 1.94–2.77). The vaccine was mainly prescribed by family physicians (58%). Influenza vaccination in pregnant women in France remains very low, particularly in younger, healthy women, and measures such as information campaigns towards pregnant women and studies of the knowledge, attitudes, and practices of the health care professionals need to be undertaken to improve the coverage.
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Affiliation(s)
- Mélodie Corbeau
- Department of General Practice, Faculty of Medicine, University Clermont Auvergne, 28 Place Henri Dunant, 63001, Clermont-Ferrand, France
| | - Aurélien Mulliez
- Biostatistics Unit (Clinical Research and Innovation Department), University Hospital Clermont-Ferrand, Clermont-Ferrand, France
| | - Chouki Chenaf
- Service de Pharmacologie Médicale, Centres Addictovigilance et Pharmacovigilance, Université Clermont Auvergne, CHU Clermont-Ferrand, Clermont-Ferrand, France.,Université Clermont Auvergne, INSERM, U1107 "Neuro-Dol", Clermont-Ferrand, France
| | - Bénédicte Eschalier
- Department of General Practice, Faculty of Medicine, University Clermont Auvergne, 28 Place Henri Dunant, 63001, Clermont-Ferrand, France
| | - Olivier Lesens
- Infectious and Tropical Diseases Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Philippe Vorilhon
- Department of General Practice, Faculty of Medicine, University Clermont Auvergne, 28 Place Henri Dunant, 63001, Clermont-Ferrand, France. .,Biostatistics Unit (Clinical Research and Innovation Department), University Hospital Clermont-Ferrand, Clermont-Ferrand, France. .,Université Clermont Auvergne, ACCePPT, Clermont-Ferrand, France.
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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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Vilca LM, Sarno L, Cesari E, Vidiri A, Antonazzo P, Ravennati F, Cavaliere AF, Guida M, Cetin I. Differences between influenza and pertussis vaccination uptake in pregnancy: a multi-center survey study in Italy. Eur J Public Health 2021; 31:1150-1157. [PMID: 34580721 DOI: 10.1093/eurpub/ckab095] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND A suboptimal maternal vaccination coverage in 2017-18 has been reported in Italy. The study aims were to (i) assess changes in maternal influenza and tetanus, diphtheria and acellular pertussis vaccination coverage during 2018-19 influenza season compared to the previous season (ii) estimate influenza vaccine coverage among maternal care providers (MCPs) and (iii) explore the characteristics of vaccine delivery to pregnant women. METHODS We conducted a cross-sectional survey among pregnant women and MCPs about influenza and pertussis immunization during pregnancy. We also collected information regarding prenatal care characteristics and vaccine delivery among four centers in Italy. RESULTS We recruited 483 pregnant women and 452 MCPs. The influenza and pertussis vaccine uptake among pregnant women for the season 2018-19 was 14.9% and 60.9%, respectively. MCPs' influenza vaccine uptake was 33.6%. Knowing that the flu vaccine was safe for mothers and their infants and being vaccinated in the previous influenza season were associated with higher vaccine uptake. Regarding pertussis, being a housewife was associated to lower vaccine uptake, while knowing the vaccine is effective and safe for mothers and newborns were associated with higher pertussis vaccine uptake. The single most important factor associated to higher coverage of both influenza and pertussis vaccines was receiving a health-care provider's vaccine advice. Most pregnant women (69.4%) stated that they preferred to be vaccinated in their same prenatal care setting. CONCLUSIONS Receiving a health-care provider's vaccine advice and the availability of vaccines during prenatal care visits might improve vaccination coverage among pregnant women.
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Affiliation(s)
- Luz Maria Vilca
- Unit of Obstetrics and Gynecology, Buzzi Hospital-ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy
| | - Laura Sarno
- Department of Neurosciences, Reproductive Science and Dentistry, University of Naples Federico II, Naples, Italy
| | - Elena Cesari
- Unit of Obstetrics and Gynecology, Buzzi Hospital-ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy
| | - Annalisa Vidiri
- Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Patrizio Antonazzo
- Unit of Obstetrics and Gynecology, Bufalini Hospital-AUSL Romagna, Cesena, Italy
| | - Francesca Ravennati
- Unit of Obstetrics and Gynecology, Bufalini Hospital-AUSL Romagna, Cesena, Italy.,University of Ferrara, Ferrara, Italy
| | - Anna Franca Cavaliere
- Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario "A. Gemelli" IRCCS-Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maurizio Guida
- Department of Neurosciences, Reproductive Science and Dentistry, University of Naples Federico II, Naples, Italy
| | - Irene Cetin
- Unit of Obstetrics and Gynecology, Buzzi Hospital-ASST Fatebenefratelli Sacco, University of Milan, Milan, Italy
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Bishop K, McMorrow M, Meiring S, Walaza S, Rossi L, Mhlanga S, Tempia S, Mathunjwa A, Kleynhans J, Appiah GD, McAnerney JM, Zar HJ, Cohen C. An evaluation of an influenza vaccination campaign targeting pregnant women in 27 clinics in two provinces of South Africa, 2015 - 2018. BMC Health Serv Res 2021; 21:941. [PMID: 34503508 PMCID: PMC8427945 DOI: 10.1186/s12913-021-06962-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/31/2021] [Indexed: 01/22/2023] Open
Abstract
Introduction Despite prioritization, routine antenatal influenza vaccine coverage is < 16% in South Africa. We aimed to describe maternal influenza vaccine coverage in 27 antenatal clinics (ANCs) in Gauteng and Western Cape (WC) Provinces, where in collaboration with the Department of Health (DoH), we augmented the annual influenza vaccination programme among pregnant women. Methods From 2015 through 2018, 40,230 additional doses of influenza vaccine were added to the available stock and administered as part of routine antenatal care. Educational talks were given daily and data were collected on women attending ANCs. We compared characteristics of vaccinated and unvaccinated women using multivariable logistic regression. Results We screened 62,979 pregnant women during the period when Southern Hemisphere influenza vaccines were available (27,068 in Gauteng and 35,911 in WC). Vaccine coverage at the targeted clinics was 78.7% (49,355/62682), although pregnant women in WC were more likely to be vaccinated compared to those in the Gauteng (Odds ratio (OR) =3.7 p < 0.001). Women aged 25—29 and > 35 years were less likely to be vaccinated than women aged 18—24 years (OR = 0.9 p = 0.053; OR = 0.9 p < 0.001). HIV positive status was not associated with vaccination (OR = 1.0 p = 0.266). Reasons for not vaccinating included: vaccine stock-outs where ANCs depleted available stock of vaccines and/or were awaiting delivery of vaccines (54.6%, 6949/12723), refusal/indecision (25.8%, 3285), and current illness that contraindicated vaccination (19.6%, 2489). Conclusion Antenatal vaccination uptake was likely improved by the increased vaccine supply and vaccine education offered during our campaign.
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Affiliation(s)
- Kate Bishop
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS), Johannesburg, South Africa. .,Division of Public Health Services and Response, National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS), Johannesburg, South Africa.
| | - Meredith McMorrow
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa
| | - Susan Meiring
- Division of Public Health Services and Response, National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS), Johannesburg, South Africa
| | - Sibongile Walaza
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS), Johannesburg, South Africa.,DST/NRF Vaccine Preventable Diseases/Respiratory and Meningeal Pathogens Research Unit (RMPRU), Johannesburg, South Africa
| | - Liza Rossi
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS), Johannesburg, South Africa
| | - Sarona Mhlanga
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS), Johannesburg, South Africa
| | - Stefano Tempia
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS), Johannesburg, South Africa.,Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.,Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Azwifarwi Mathunjwa
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS), Johannesburg, South Africa
| | - Jackie Kleynhans
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS), Johannesburg, South Africa.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Grace D Appiah
- Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Johanna M McAnerney
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS), Johannesburg, South Africa
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, and SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Cheryl Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases (NICD), a division of the National Health Laboratory Service (NHLS), Johannesburg, South Africa.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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7
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Okoli GN, Reddy VK, Al-Yousif Y, Neilson CJ, Mahmud SM, Abou-Setta AM. Sociodemographic and health-related determinants of seasonal influenza vaccination in pregnancy: A systematic review and meta-analysis of the evidence since 2000. Acta Obstet Gynecol Scand 2021; 100:997-1009. [PMID: 33420724 DOI: 10.1111/aogs.14079] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/12/2020] [Accepted: 12/31/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Vaccination is considered to be the most practical and effective preventative measure against influenza. It is highly recommended for population subgroups most at risk of developing complications, including pregnant women. However, seasonal influenza vaccine uptake remains suboptimal among pregnant women, even in jurisdictions with universal vaccination. We summarized the evidence on the determinants of seasonal influenza vaccine uptake during pregnancy to better understand factors that influence vaccine uptake among pregnant women. MATERIAL AND METHODS We systematically searched MEDLINE, Embase and CINAHL from January 2000 to February 2020 for publications in English reporting on sociodemographic and/or health-related determinants of seasonal influenza vaccine uptake during pregnancy. Two reviewers independently included studies. One reviewer extracted data and assessed study quality, and another reviewer checked extracted data and study quality assessments for errors. Disagreements were resolved through consensus, or a third reviewer. We meta-analyzed using the inverse variance, random-effects method, and reported the odds ratios (OR) and 95% confidence intervals (CI). RESULTS From 1663 retrieved citations, we included 36 studies. The following factors were associated with increased seasonal influenza vaccine uptake: Older age (20 studies: OR 1.13, 95% CI 1.07-1.20), being nulliparous (13 studies: OR 1.26, 95% CI 1.15-1.38), married (8 studies: OR 1.11, 95% CI 1.07-1.15), employed (4 studies: OR 1.13, 95% CI 1.02-1.24), a non-smoker (8 studies: OR 1.25, 95% CI 1.04-1.51) and having prenatal care (3 studies: OR 3.36, 95% CI 2.25-5.02), a chronic condition (6 studies: OR 1.30, 95% CI 1.17-1.44), been previously vaccinated (9 studies: OR 4.88, 95% CI 3.14-7.57) and living in a rural area (9 studies: OR 1.09, 95% CI 1.05-1.14). Compared with being black, being white was also associated with increased seasonal influenza vaccine uptake (11 studies: OR 1.30, 95% CI 1.20-1.41). CONCLUSIONS The evidence suggests that several sociodemographic and health-related factors may determine seasonal influenza vaccination in pregnancy, and that parity, history of influenza vaccination, prenatal care and comorbidity status may be influential.
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Affiliation(s)
- George N Okoli
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,George & Fay Yee Center for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada.,Vaccine and Drug Evaluation Center, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Viraj K Reddy
- George & Fay Yee Center for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Yahya Al-Yousif
- George & Fay Yee Center for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Christine J Neilson
- Neil John Maclean Health Sciences Library, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Salaheddin M Mahmud
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Vaccine and Drug Evaluation Center, University of Manitoba, Winnipeg, Manitoba, Canada.,Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ahmed M Abou-Setta
- George & Fay Yee Center for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada.,Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Skirrow H, Holder B, Meinel A, Narh E, Donaldson B, Bosanquet A, Barnett S, Kampmann B. Evaluation of a midwife-led, hospital based vaccination service for pregnant women. Hum Vaccin Immunother 2021; 17:237-246. [PMID: 32873132 PMCID: PMC7872094 DOI: 10.1080/21645515.2020.1770515] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 05/13/2020] [Indexed: 11/29/2022] Open
Abstract
Background: Vaccines against whooping cough (pertussis) and seasonal-influenza are recommended for pregnant women in England. Uptake however varies regionally and by ethnicity. Pregnant women are traditionally vaccinated in primary care, though some hospitals now offer vaccines through antenatal clinics. This mixed-methods evaluation describes the demographic characteristics of women seen in a hospital midwife-led antenatal vaccine clinic and explores vaccine decision making. Methods: Descriptive statistics of women seen in a London hospital's midwife-led vaccine clinic were generated from electronic routine maternity records, including data on ethnicity, parity, age and deprivation indices. Reasons for vaccine decline given by women to midwives were categorized by themes. Qualitative interviews of women seen in the clinic were also undertaken. Results: Between 1st April 2017 and 31st March 2018 the vaccine clinic saw 1501 pregnant women. Of these, 83% received pertussis vaccine and (during flu season) 51% received influenza vaccine, from the clinic. Fewer Black Afro-Caribbean women seen by the clinic were vaccinated, compared to other ethnicities with only 68% receiving pertussis and 34% flu vaccines respectively (p < .05). Among all women delivering at the hospital over the year, 42%, (1334/3147) were vaccinated by the clinic. Qualitative interviews found that reassurance from healthcare professionals, particularly midwives, was the most important factor influencing maternal vaccine decisions. Conclusions: Midwife-led hospital clinics can offer an effective alternative to primary care provision for vaccines in pregnancy. Consistent with previous work, vaccine uptake varied by ethnicity. Midwives play a key role in the provision of vaccine services and influence women's vaccine decisions.
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Affiliation(s)
- Helen Skirrow
- Imperial College Healthcare NHS Trust, London
- Section of Paediatrics, Department of Infectious Diseases, Imperial College London, London
- School of Public Health, Imperial College London, London
| | - Beth Holder
- Section of Paediatrics, Department of Infectious Diseases, Imperial College London, London
- Institute of Reproductive and Developmental Biology, Department of Metabolism, Digestion and Reproduction, Imperial College London, London
| | | | - Evelyn Narh
- Imperial College Healthcare NHS Trust, London
| | - Beverly Donaldson
- Section of Paediatrics, Department of Infectious Diseases, Imperial College London, London
| | - Anna Bosanquet
- Section of Paediatrics, Department of Infectious Diseases, Imperial College London, London
| | - Sara Barnett
- Section of Paediatrics, Department of Infectious Diseases, Imperial College London, London
| | - Beate Kampmann
- Imperial College Healthcare NHS Trust, London
- Section of Paediatrics, Department of Infectious Diseases, Imperial College London, London
- The Vaccine Centre, Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London
- Vaccines & Immunity Theme, MRC Unit the Gambia at the London School of Hygiene and Tropical Medicine, Banjul
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9
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Bessis S. [Respiratory viral infections (other than COVID-19)]. Med Mal Infect 2020; 50:8S12-8S19. [PMID: 33357971 PMCID: PMC7756179 DOI: 10.1016/s0399-077x(20)30778-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- S Bessis
- Service de maladies infectieuses et tropicales, Hôpital Raymond-Poincaré - Assistance publique hôpitaux de Paris (AP-HP), 104, boulevard Raymond-Poincaré, 92380 Garches, France.
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10
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Howe AS, Pointon L, Gauld N, Paynter J, Willing E, Turner N. Pertussis and influenza immunisation coverage of pregnant women in New Zealand. Vaccine 2020; 38:6766-6776. [PMID: 32868133 DOI: 10.1016/j.vaccine.2020.08.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Immunisation is an important public health policy and measuring coverage is imperative to identify gaps and monitor trends. New Zealand (NZ), like many countries, does not routinely publish coverage of immunisations given during pregnancy. Therefore, this study examined pregnancy immunisation coverage of all pregnant NZ women between 2013 and 2018, and what factors affected uptake. METHODS A retrospective cohort study of pregnant women who delivered between 2013 and 2018 was undertaken using administrative datasets. Maternity and immunisation data were linked to determine coverage of pertussis and influenza vaccinations in pregnancy. Generalised estimating equations were used to estimate the odds of receiving a vaccination during pregnancy. RESULTS From 2013 to 2018 data were available for 323,622 pregnant women, of whom 21.7% received maternal influenza immunisations and 25.7% maternal pertussis immunisations. Coverage for both vaccines increased over time, pertussis increased from 10.2% to 43.6% and influenza from 11.2% to 30.8%. The odds of being vaccinated, with either vaccine, during pregnancy increased with increasing age and decreasing deprivation. Compared to NZ European or Other women, Māori and Pacific women had lower odds of receiving a maternal pertussis (OR:0.55, 95% CI: 0.54, 0.57; OR:0.60, 95% CI: 0.58, 0.62, respectively) and influenza (OR: 0.69, 95% CI: 0.67, 0.71; OR:0.90, 95% CI: 0.87, 0.94, respectively) immunisations during pregnancy. Women were also more likely to be vaccinated against pertussis if they received antenatal care from a General Practitioner or Obstetrician compared to a Midwife. A similar pattern was seen for influenza vaccination. CONCLUSION Gaps in maternal coverage for pertussis and influenza exist and work is needed to reduce immunisation inequities.
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Affiliation(s)
- Anna S Howe
- Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, New Zealand.
| | - Leah Pointon
- Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, New Zealand.
| | - Natalie Gauld
- Department of Paediatrics: Child and Youth Health, University of Auckland, New Zealand; School of Pharmacy, University of Auckland, New Zealand.
| | - Janine Paynter
- Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, New Zealand.
| | - Esther Willing
- Kōhatu - Centre for Hauora Māori, Division of Health Sciences, University of Otago, New Zealand.
| | - Nikki Turner
- Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, New Zealand; Immunisation Advisory Centre, University of Auckland, New Zealand.
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Influenza Vaccination Experiences of Pregnant Women as a Predictor of the Intention to Become Vaccinated in Future Pregnancies in Spain. Vaccines (Basel) 2020; 8:vaccines8020291. [PMID: 32527002 PMCID: PMC7350003 DOI: 10.3390/vaccines8020291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/26/2020] [Accepted: 06/05/2020] [Indexed: 11/16/2022] Open
Abstract
A good perception of the vaccines administered during pregnancy favors immunization coverage, which is still not optimal for the influenza vaccine. To understand the predisposition towards vaccination in future pregnancies, a study was performed that evaluated the experiences of women with the vaccine or influenza. A cross-sectional study was conducted through telephone interviews given to a total of 683 postpartum women in two health departments from the Valencia Community (Spain). This interview asked about their intention of becoming vaccinated in future pregnancies and whether they were favor or against vaccination. Most of them, 98.5% (n = 673 [95% CI: 97.6–99.4]) (p < 0.001) declared having received the systematic vaccines throughout their lives. The ones who were vaccinated against influenza, 91.9% (n = 387 [95% CI: 89.2–94.6]) (p < 0.001) manifested they would do so in future pregnancies. The probability of future non-vaccination was modeled, which was related to an unfavorable opinion towards vaccines (OR = 4.07 [95% CI: 2.01–8.24]) (p < 0.001), having suffered from influenza during pregnancy (OR = 3.84 [95% CI: 1.41–10.42]) (p < 0.05), and not having been vaccinated during previous pregnancies (OR = 38.47 [95% CI: 23.58–62.76]) (p < 0.001). Vaccination during pregnancy increases the intent of vaccination in the future.
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12
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Merritt TA, Rasmussen SA, Bright MA, Roussos-Ross D, Sims SM, Gurka MJ, Thompson LA. Variation in Tdap and Influenza Vaccination Coverage Among Pregnant Women by Insurance Type - Florida, 2016-2018. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2020; 69:72-76. [PMID: 31971934 PMCID: PMC7367038 DOI: 10.15585/mmwr.mm6903a4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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13
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Descamps A, Launay O, Bonnet C, Blondel B. Seasonal influenza vaccine uptake and vaccine refusal among pregnant women in France: results from a national survey. Hum Vaccin Immunother 2019; 16:1093-1100. [PMID: 31725346 DOI: 10.1080/21645515.2019.1688035] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Pregnant women and infants are at high risk for severe influenza and many countries, including France, recommend annual influenza immunization during pregnancy. We aimed to estimate influenza vaccination and refusal rates and assess associated factors among pregnant women during the 2015-16 season in France. We used data from a national representative sample of women who gave birth in March 2016 and were interviewed before hospital discharge (N = 11,752). In the multivariable analysis, robust Poisson regression models were used to study associations with maternal characteristics and prenatal care characteristics. Influenza vaccine coverage among pregnant women was 7.4% (95% confidence interval [CI]: 6.9-7.9). Only 24.9% (95% CI: 24.2-25.7) of women said that they received a care provider proposal for vaccination and 70.4% (95% CI: 68.7-72.0) of these declined it. Vaccine uptake was associated with low parity (prevalence ratio [PR] = 2.1; 95% CI: 1.4-3.2 for parity 0 vs ≥ 3), high educational level (PR = 2.5; 95% CI: 2.0-3.2), healthcare occupation during pregnancy (PR = 1.8; 95% CI: 1.5-2.1) and preexisting conditions at risk for influenza (PR = 1.7; 95% CI: 1.3-2.2). Women were more frequently vaccinated when their main care provider was a general practitioner. Multiparae women and those with medium or low educational level were significantly more likely than others to decline influenza vaccine after a provider proposal. Influenza vaccine coverage is very low in France, mainly because of infrequent care provider proposals and also frequent women's refusals. Effective interventions should be designed to promote vaccination among medical professionals and reduce vaccine hesitancy among pregnant women.
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Affiliation(s)
- Alexandre Descamps
- CIC Cochin Pasteur, Hôpital Cochin Broca Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France
| | - Odile Launay
- CIC Cochin Pasteur, Hôpital Cochin Broca Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,INSERM, CIC 1417, F-CRIN, I-REIVAC, Université de Paris, Paris, France
| | - Camille Bonnet
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), CRESS, INSERM, INRA, Université de Paris, Paris, France
| | - Béatrice Blondel
- Obstetrical, Perinatal and Pediatric Epidemiology Research Team (Epopé), CRESS, INSERM, INRA, Université de Paris, Paris, France
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