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Rodríguez-Blanco N, Ibarra-González L, Vegara-López I, Orts-Cortés MI. [Evaluation of a community-based intervention to increase influenza vaccination coverage in pregnant women]. Aten Primaria 2023; 55:102652. [PMID: 37210972 PMCID: PMC10209675 DOI: 10.1016/j.aprim.2023.102652] [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: 01/30/2023] [Revised: 03/28/2023] [Accepted: 04/17/2023] [Indexed: 05/23/2023] Open
Abstract
OBJECTIVE To know the impact of the educational intervention carried out on the professionals of a basic health area and their community participation group, which make up the intervention group (IG), and to analyze its repercussion on the vaccination coverage achieved for influenza in the risk group (pregnant and puerperal women) comparing it with its neighboring basic zone, which makes up the control group (CG), during the 2019/20 vaccination season. DESIGN Quasi-experimental study of community intervention. SITE: Two basic health zones belonging to the Elche-Crevillente health department, Spain. PARTICIPANTS Pregnant and postpartum women from 2 basic health areas and the community participation group. Health professionals directly related to the flu vaccination campaign. INTERVENTIONS Training session for the IG prior to the 2019/20 flu campaign. MAIN MEASUREMENTS Attitudes towards influenza vaccination in health professionals through the validated CAPSVA questionnaire and the vaccination coverage of pregnant and postpartum women through the Nominal Vaccine Registry and their acceptance of the vaccine in the midwife's office. RESULTS The influenza vaccination coverage data recorded in Nominal Vaccine Registry for pregnant and puerperal women was 26.4% (n=207) in the IG and 19.7% (n=144) in the CG (p=0.001), with an incidence ratio of 1.34, thus achieving 34% more vaccination in the IG. Acceptance for vaccination in the midwife's office was also high, with 96.5% immunization in IG vs. 89.0% in CG, with a RR=1.09 (95% CI 1.01-1.62). CONCLUSIONS Joint training strategies for professionals and community assets improve the results of vaccination coverage.
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Affiliation(s)
- Noelia Rodríguez-Blanco
- Departamento de Enfermería, Universidad Cardenal Herrera-CEU, CEU Universities, Elche, Alicante, España; Departamento de Obstetricia y Ginecología, Hospital Marina Baixa, Villajoyosa, Alicante, España.
| | | | - Irene Vegara-López
- Departamento de Enfermería, Universidad Cardenal Herrera-CEU, CEU Universities, Elche, Alicante, España; Servicio de Obstetricia y Ginecología, Hospital Universitario del Vinalopó, Elche, Alicante, España
| | - María Isabel Orts-Cortés
- Departamento de Enfermería, Universidad de Alicante (BALMIS), Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España; Unidad de Investigación en Cuidados y Servicios de Salud (Investén-isciii), Instituto de Salud Carlos III, Madrid, España; Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, España
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Ruiz-Botia I, Riera-Bosch MT, Rodríguez-Losada O, Soler-Palacín P, Melendo S, Moraga-Llop F, Balcells-Ramírez J, Otero-Romero S, Armadans-Gil L. Impact of vaccinating pregnant women against pertussis on hospitalizations of children under one year of age in a tertiary hospital in Catalonia. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2022; 40:473-478. [PMID: 35752569 DOI: 10.1016/j.eimce.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/25/2021] [Accepted: 04/05/2021] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The recommendation for pertussis vaccination in pregnancy was established in Catalonia in February 2014. The objective of this study was to compare the hospitalisation rate for pertussis in children under one year of age before and after the implementation of the vaccination programme. METHODS Observational and retrospective study of patients under one year of age admitted to hospital with a diagnosis of pertussis. The hospitalisation rate of patients under one year of age of the period prior to the vaccination programme (2008-2013) was compared with the period with vaccination programme (2014-2019) in the total of children under one year of age and in 2 subgroups: children under 3 months and between 3-11 months. RESULTS Hospitalization rate was significantly lower in the period with vaccination programme in children under one year of age and specifically in children under 3 months (2.43 vs. 4.72 per 1000 person-years and 6.47 vs. 13.11 per 1000 person-years, respectively). The rate ratios were: 0.51 (95% CI 0.36-0.73) for children under one year of age; 0.49 (95% CI 0.32-0.75) for those younger than 3 months and 0.56 (95% CI 0.30-1.03) for those with 3-11 months. No statistically significant differences were observed in the clinical severity between both periods. CONCLUSION The introduction of the pertussis vaccination programme in pregnancy was associated with a global lower hospitalisation rate for pertussis in children under one year of age and specifically in those under 3 months of age.
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Affiliation(s)
- Irene Ruiz-Botia
- Servicio de Pediatría, Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
| | | | - Olalla Rodríguez-Losada
- Unidad de Urgencias Pediátricas, Hospital Infantil Vall d'Hebron, Vall d'Hebron Barcelona Campus Hospitalari, Barcelona, Spain
| | - Pere Soler-Palacín
- Unidad de Patología Infecciosa e Inmunodeficiencias de Pediatría, Hospital Infantil Vall d'Hebron, Vall d'Hebron Barcelona Campus Hospitalari, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - Susana Melendo
- Unidad de Patología Infecciosa e Inmunodeficiencias de Pediatría, Hospital Infantil Vall d'Hebron, Vall d'Hebron Barcelona Campus Hospitalari, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Fernando Moraga-Llop
- Unidad de Patología Infecciosa e Inmunodeficiencias de Pediatría, Hospital Infantil Vall d'Hebron, Vall d'Hebron Barcelona Campus Hospitalari, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joan Balcells-Ramírez
- Unidad de Cuidados Intensivos Pediátricos, Hospital Infantil Vall d'Hebron, Vall d'Hebron Barcelona Campus Hospitalari, Barcelona, Spain
| | - Susana Otero-Romero
- Servicio de Medicina Preventiva y Epidemiología, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Campus Hospitalari, Barcelona, Spain
| | - Lluís Armadans-Gil
- Servicio de Medicina Preventiva y Epidemiología, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Campus Hospitalari, Barcelona, Spain
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Knowledge, Perceptions, Attitudes and Practices of Midwives Regarding Maternal Influenza and Pertussis Vaccination: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148391. [PMID: 35886242 PMCID: PMC9322479 DOI: 10.3390/ijerph19148391] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/28/2022] [Accepted: 07/07/2022] [Indexed: 02/04/2023]
Abstract
The coverage of maternal vaccination against pertussis and, particularly, influenza is lower than expected. The lack of recommendation from healthcare providers conditions non-vaccination in pregnant women. The purpose was to determine the knowledge, perceptions, attitudes and practices of midwives regarding maternal influenza and pertussis vaccination. A qualitative descriptive study based on semi-structured, face-to-face interviews with seventeen midwives was conducted, including purposive sampling and thematic analyses. Midwives had disparate knowledge and perceptions about the severity of influenza and pertussis in pregnant women, and influenza was not considered very serious. The vaccines were generally considered safe. However, because midwives did not have enough information about the safety of the influenza vaccine, there was a tendency not to recommend it. While most midwives had a positive attitude toward vaccination, their advocation for vaccination against influenza was not as clear as it was for pertussis. Not wanting to influence the decision and assuming an informative–facilitating role also led providers to recommend the influenza vaccine less frequently. Midwives are among the main sources of professional advice for pregnant women. Addressing their understanding and professional practices regarding maternal vaccination is key to change the attitude of pregnant women and thus increase vaccine uptake among them, particularly for influenza.
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Chang YW, Tsai SM, Lin PC, Chou FH. Efficacy of a Smartphone Application to Promote Maternal Influenza Vaccination: A Randomized Controlled Trial. Vaccines (Basel) 2022; 10:vaccines10030369. [PMID: 35335002 PMCID: PMC8954751 DOI: 10.3390/vaccines10030369] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/22/2022] [Accepted: 02/25/2022] [Indexed: 12/10/2022] Open
Abstract
The maternal vaccine coverage rate has been low in Taiwan. We developed an “Influenza Vaccination Reminder Application” and evaluated its efficacy in improving vaccination intention among pregnant women in Taiwan. A randomized controlled trial was conducted to compare the positive change in vaccination intention between the experimental group and the control group. Pregnant women who were more than 20 years old and at less than 32 weeks of gestation were recruited from four regional hospitals in southern Taiwan during November 2020 to April 2021. Pregnant women were randomly assigned to the experimental group, to whom the “Influenza Vaccination Reminder Application” was provided for at least two months, while pregnant women in the control group received regular maternal education only. The differences in knowledge about influenza and its vaccines, attitudes towards maternal influenza vaccination, and behavior intention of influenza vaccination among pregnant women before and after the experiment intervention were compared between two groups. The results included 126 women in the experimental group and 117 women in the control group and showed that the “Influenza Vaccination Reminder Application” increased pregnant women’s knowledge about influenza and vaccines (percentage increase in the experimental group and control group: 11.64% vs. 7.39%), strengthened their positive attitudes towards maternal influenza vaccination (percentage increase: 5.39% vs. 1.44%), and promoted positive behavioral intention toward influenza vaccination (proportion of participants with positive change in vaccination intention: 17.46% vs. 7.69%). The study supports use of “Influenza Vaccination Reminder Application” to promote the behavior intention of influenza vaccination among pregnant women in Taiwan.
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Affiliation(s)
- Ya-Wen Chang
- Department of Nursing, National Tainan Junior College of Nursing, Tainan City 700007, Taiwan; (Y.-W.C.); (S.-M.T.); (P.-C.L.)
| | - Shiow-Meei Tsai
- Department of Nursing, National Tainan Junior College of Nursing, Tainan City 700007, Taiwan; (Y.-W.C.); (S.-M.T.); (P.-C.L.)
| | - Pao-Chen Lin
- Department of Nursing, National Tainan Junior College of Nursing, Tainan City 700007, Taiwan; (Y.-W.C.); (S.-M.T.); (P.-C.L.)
| | - Fan-Hao Chou
- College of Nursing, Kaohsiung Medical University, Kaohsiung City 80708, Taiwan
- Correspondence:
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Baïssas T, Boisnard F, Cuesta Esteve I, Garcia Sánchez M, Jones CE, Rigoine de Fougerolles T, Tan L, Vitoux O, Klein C. Vaccination in pregnancy against pertussis and seasonal influenza: key learnings and components from high-performing vaccine programmes in three countries: the United Kingdom, the United States and Spain. BMC Public Health 2021; 21:2182. [PMID: 34844567 PMCID: PMC8628032 DOI: 10.1186/s12889-021-12198-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 11/03/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Pertussis and seasonal influenza are responsible for significant maternal, neonatal, and infant morbidity and mortality, but vaccine coverage rates (VCR) for both pertussis (administered as a tetanus, diphtheria, acellular pertussis [Tdap] vaccination) and seasonal influenza in pregnancy remain generally low. Only a small number of countries, including Spain, the United Kingdom (UK), and the United States (US), have high Tdap and seasonal influenza VCRs in pregnancy. The purpose of this study was to identify the key factors that contributed to the high VCRs observed in these countries. METHODS The experience from both Tdap and seasonal influenza vaccination programmes during pregnancy were documented in Spain, the UK, and the US using a three-step approach. A literature review yielded 157 publications, and a further 117 documents were selected through desk research. A published five-pillar VCR framework for influenza was amended to evaluate the specific contributing factors leading to high Tdap and seasonal influenza VCRs among pregnant women. RESULTS The analysis identified components that contributed to higher VCR in pregnant women across three different healthcare systems in Spain, UK, and US. The combination of several key interventions in each country led to a rapid increase in VCR that reached near-optimal levels (i.e. 75% for seasonal influenza) within a few years. As well as inclusion in national immunisation programme and vaccine reimbursement, key components that were identified included the mobilisation of health authorities, prenatal care Healthcare Professionals (HCP) and scientific societies, the inclusion of vaccination in antenatal medical guidance, the provision of educational material to HCPs, and a strong disease awareness driven by recent pertussis outbreaks in each country. CONCLUSIONS Although there is no simple, universal solution to improving sub-optimal VCRs, the list of components identified in this study from three countries with high-performing Tdap and seasonal influenza vaccination programmes provides a basis for public health and medical stakeholders in other countries to define strategies to successfully implement national vaccination programmes for pregnant women.
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Affiliation(s)
| | | | | | | | - Christine E Jones
- Faculty of Medicine and Institute for Life Sciences University of Southampton and NIHR Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Litjen Tan
- Immunisation Action Coalition, Saint Paul, MN, USA
| | | | - Christina Klein
- Sanofi Pasteur, 14, Espace Henry Vallée, 69007, Lyon, France.
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Chang YW, Chou FH. Acceptance of Pertussis Vaccination among Pregnant Women in Taiwan. J Community Health Nurs 2021; 38:85-102. [PMID: 33949260 DOI: 10.1080/07370016.2021.1887565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This cross-sectional study assessed prenatal pertussis vaccination acceptance in Taiwan. A sample of pregnant women from five private clinics in Taiwan was recruited. Demographics, experience of prenatal vaccinations, key considerations, knowledge, and attitude about pertussis and its vaccination were measured. Among 505 participants, the vaccination rate, including planned vaccination, was 29.7%. Factors associated with acceptance included clinic location, primary caregiver of the newborn, newborns with siblings, previous influenza vaccination history, knowledge and attitude toward pertussis and its vaccination. Public health agencies should provide free vaccinations, clarify misinformation, and publicize prevention information, to improve prenatal pertussis vaccination acceptance.
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Affiliation(s)
- Ya-Wen Chang
- College of Nursing, Kaohsiung Medical University, Taiwan, R.O.C.,Department of Nursing, National Tainan Institute of Nursing, Taiwan, R.O.C
| | - Fan-Hao Chou
- College of Nursing, Kaohsiung Medical University, Taiwan, R.O.C
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Arreciado Marañón A, Fernández-Cano MI, Montero-Pons L, Feijoo-Cid M, Reyes-Lacalle A, Cabedo-Ferreiro RM, Manresa-Domínguez JM, Falguera-Puig G. Understanding factors that influence the decision to be vaccinated against influenza and pertussis in pregnancy: A qualitative study. J Clin Nurs 2021; 31:1531-1546. [PMID: 34423873 DOI: 10.1111/jocn.16006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 07/29/2021] [Accepted: 08/04/2021] [Indexed: 01/08/2023]
Abstract
AIMS AND OBJECTIVES To identify how pregnant women perceive pertussis and influenza and the factors that influence their decision to be vaccinated. BACKGROUND Suffering from influenza during pregnancy increases complications in the pregnant woman, foetus and newborn. Pertussis in children under six months of age causes severe complications. Maternal vaccination against influenza and pertussis is effective and safe. However, vaccination rates are insufficient. DESIGN We conducted a qualitative descriptive study, using semi-structured interviews. This research adheres to the COREQ guidelines and checklist. METHODS We carried out 18 semi-structured face-to-face interviews with pregnant women, using intentional sampling and thematic analysis. RESULTS We identified an overarching theme, 'factors that influenced participants' decision to be vaccinated or not', which was composed of four subthemes that were in turn made up of 12 categories. The factors that influenced participants' decision to be vaccinated against influenza and pertussis were related to their knowledge of and their perception of risk for these diseases. Participants perceived the risk of pertussis to be greater, and they focused their concern on the newborn. The recommendations and convictions of nurse-midwives were the most important factors encouraging vaccination. Participants trusted their nurse-midwives and most reported that they would have been vaccinated if their midwife had recommended it. Other factors were linked to lack of information, fear and concerns about economic interests. CONCLUSIONS The convictions and actions of the nurse-midwife in recommending vaccination to pregnant women are decisive. Strategies to improve vaccination rates should be directed to helping health professionals understand how their practice affects the final decision of pregnant women. RELEVANCE TO CLINICAL PRACTICE Understanding the factors that limit vaccination rates among pregnant women provides valuable information to nurse-midwives that can help to improve vaccination strategies and practices. Increased maternal vaccination rates would reduce morbidity and mortality among pregnant women and newborns.
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Affiliation(s)
- Antonia Arreciado Marañón
- Department of Nursing, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Multidisciplinary Research Group in Health and Society (GREMSAS), Barcelona, Spain
| | - María Isabel Fernández-Cano
- Department of Nursing, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Multidisciplinary Research Group in Health and Society (GREMSAS), Barcelona, Spain
| | - Laura Montero-Pons
- Atenció a la Salut Sexual i Reproductiva de Santa Coloma de Gramenet, Direcció d'Atenció Primària Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain.,Research Group Atenció a la Salut Sexual i Reproductiva (GRASSIR), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Maria Feijoo-Cid
- Department of Nursing, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Multidisciplinary Research Group in Health and Society (GREMSAS), Barcelona, Spain
| | - Azahara Reyes-Lacalle
- Research Group Atenció a la Salut Sexual i Reproductiva (GRASSIR), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.,Atenció a la Salut Sexual i Reproductiva de Sabadell, Direcció d'Atenció Primària Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
| | - Rosa Maria Cabedo-Ferreiro
- Research Group Atenció a la Salut Sexual i Reproductiva (GRASSIR), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.,Atenció a la Salut Sexual i Reproductiva de Granollers, Direcció d'Atenció Primària Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
| | - Josep Maria Manresa-Domínguez
- Department of Nursing, Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Multidisciplinary Research Group in Health and Society (GREMSAS), Barcelona, Spain.,Unitat de Suport a la Recerca Metropolitana Nord, Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAPJGol), Barcelona, Spain
| | - Gemma Falguera-Puig
- Research Group Atenció a la Salut Sexual i Reproductiva (GRASSIR), Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.,Atenció a la Salut Sexual i Reproductiva Metropolitana Nord, Direcció d'Atenció Primària Metropolitana Nord, Institut Català de la Salut, Barcelona, Spain
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Ruiz-Botia I, Riera-Bosch MT, Rodríguez-Losada O, Soler-Palacín P, Melendo S, Moraga-Llop F, Balcells-Ramírez J, Otero-Romero S, Armadans-Gil L. Impact of vaccinating pregnant women against pertussis on hospitalizations of children under one year of age in a tertiary hospital in Catalonia. Enferm Infecc Microbiol Clin 2021; 40:S0213-005X(21)00088-4. [PMID: 34020822 DOI: 10.1016/j.eimc.2021.04.004] [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: 02/04/2021] [Revised: 03/25/2021] [Accepted: 04/05/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The recommendation for pertussis vaccination in pregnancy was established in Catalonia in February 2014. The objective of this study was to compare the hospitalization rate for pertussis in children under one year of age before and after the implementation of the vaccination program. METHODS Observational and retrospective study of patients under one year of age admitted to hospital with a diagnosis of pertussis. The hospitalization rate of patients under one year of age of the period prior to the vaccination program (2008-2013) was compared with the period with vaccination program (2014-2019) in the total of children under one year of age and in 2subgroups: children under 3 months and between 3-11 months. RESULTS Hospitalization rate was significantly lower in the period with vaccination program in children under one year of age and specifically in children under 3 months (2.43 vs. 4.72 per 1,000 person-years and 6.47 vs. 13.11 per 1,000 person-years, respectively). The rate ratios were: 0.51 (95% CI 0.36-0.73) for children under one year of age; 0.49 (95% CI 0.32-0.75) for those younger than 3 months and 0.56 (95% CI 0.30-1.03) for those with 3-11 months. No statistically significant differences were observed in the clinical severity between both periods. CONCLUSION The introduction of the pertussis vaccination program in pregnancy was associated with a global lower hospitalization rate for pertussis in children under one year of age and specifically in those under 3 months of age.
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Affiliation(s)
- Irene Ruiz-Botia
- Servicio de Pediatría, Hospital Universitari General de Catalunya, Sant Cugat del Vallès, Barcelona, España
| | | | - Olalla Rodríguez-Losada
- Unidad de Urgencias Pediátricas, Hospital Infantil Vall d'Hebron, Vall d'Hebron Barcelona Campus Hospitalari, Barcelona, España
| | - Pere Soler-Palacín
- Unidad de Patología Infecciosa e Inmunodeficiencias de Pediatría, Hospital Infantil Vall d'Hebron, Vall d'Hebron Barcelona Campus Hospitalari, Universitat Autònoma de Barcelona, Barcelona, España.
| | - Susana Melendo
- Unidad de Patología Infecciosa e Inmunodeficiencias de Pediatría, Hospital Infantil Vall d'Hebron, Vall d'Hebron Barcelona Campus Hospitalari, Universitat Autònoma de Barcelona, Barcelona, España
| | - Fernando Moraga-Llop
- Unidad de Patología Infecciosa e Inmunodeficiencias de Pediatría, Hospital Infantil Vall d'Hebron, Vall d'Hebron Barcelona Campus Hospitalari, Universitat Autònoma de Barcelona, Barcelona, España
| | - Joan Balcells-Ramírez
- Unidad de Cuidados Intensivos Pediátricos, Hospital Infantil Vall d'Hebron, Vall d'Hebron Barcelona Campus Hospitalari, Barcelona, España
| | - Susana Otero-Romero
- Servicio de Medicina Preventiva y Epidemiología, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Campus Hospitalari, Barcelona, España
| | - Lluís Armadans-Gil
- Servicio de Medicina Preventiva y Epidemiología, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Campus Hospitalari, Barcelona, España
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Rodríguez-Blanco N, Montero-Navarro S, Botella-Rico JM, Felipe-Gómez AJ, Sánchez-Más J, Tuells J. Willingness to Be Vaccinated against COVID-19 in Spain before the Start of Vaccination: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105272. [PMID: 34063476 PMCID: PMC8155897 DOI: 10.3390/ijerph18105272] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/05/2021] [Accepted: 05/05/2021] [Indexed: 01/21/2023]
Abstract
Vaccine hesitancy has increased in the past few years, influenced by the socio-cultural differences, political populism, or concerns related to the effectiveness and safety of some vaccines, resulting a feeling of distrust. This feeling can become a barrier against the achievement of the immunity necessary to stop the expansion of COVID-19. The aim of this study was to evaluate the acceptance of the vaccine against COVID-19 in Spain, as well as to identify the factors that have an influence on the concerns and attitudes of people against accepting the vaccine in the months prior to the start of vaccination on December 2020. An online questionnaire was created to obtain information about (1) sociodemographic characteristics; (2) concerns and sources of information about vaccines; and (3) attitudes about vaccination and state of health. A multivariate logistic regression was performed to identify the influencing factors. Of the 2501 participants, 1207 (48.3%) would accept the COVID-19 vaccine, 623 (24.9%) were hesitant, and 671 (26.8%) would reject it. The logistic regression showed that being male, older than 60, married, retired, with a high level of education, or with a leftist political inclination, could increase the probability of accepting the COVID-19 vaccine. Disinformation and the lack of political consensus were the main sources of distrust. The patients with hypertension, immunodepression, hypercholesterolemia, or respiratory disease, or were overweight, showed a greater acceptance to the vaccine, while those with cancer took the longest to accept it. A low acceptance of the vaccine against COVID-19 was observed among the Spanish population in the phase prior to its availability, and the main fears of the population were identified. It is necessary to offer correct and transparent information about these vaccines to reduce the concerns and increase the trust of the population, to thereby guarantee the success of the vaccination campaigns.
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Affiliation(s)
- Noelia Rodríguez-Blanco
- Department of Obstetrics and Gynaecology, Marina Baixa University Hospital, Av. Alcalde En Jaume Botella Mayor, 7, 03570 Villajoyosa, Spain
- Biomedical Sciences Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Plaza Reyes Católicos, 19, 03204 Elche, Spain; (A.J.F.-G.); (J.S.-M.)
- Correspondence: ; Tel.: +34-965426486
| | - Sergio Montero-Navarro
- Physical Therapy Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Plaza Reyes Católicos, 19, 03204 Elche, Spain; (S.M.-N.); (J.M.B.-R.)
| | - José M. Botella-Rico
- Physical Therapy Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Plaza Reyes Católicos, 19, 03204 Elche, Spain; (S.M.-N.); (J.M.B.-R.)
| | - Antonio J. Felipe-Gómez
- Biomedical Sciences Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Plaza Reyes Católicos, 19, 03204 Elche, Spain; (A.J.F.-G.); (J.S.-M.)
| | - Jesús Sánchez-Más
- Biomedical Sciences Department, Health Sciences Faculty, CEU-Cardenal Herrera University, CEU Universities, Plaza Reyes Católicos, 19, 03204 Elche, Spain; (A.J.F.-G.); (J.S.-M.)
| | - José Tuells
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, San Vicente del Raspeig, 03690 Alicante, Spain;
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Tuells J, Egoavil CM, Morales-Moreno I, Fortes-Montoya E, Salazar-García C, Rodríguez-Blanco N. Knowledge, Attitudes, and Sources of Information on Vaccines in Spanish Nursing Students: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073356. [PMID: 33805085 PMCID: PMC8036398 DOI: 10.3390/ijerph18073356] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/13/2021] [Accepted: 03/18/2021] [Indexed: 12/25/2022]
Abstract
Health professionals are the most influential and main sources of information about vaccines for the general population, as they are regarded as role models by patients and society. The objective of the present study was to determine the knowledge and attitudes of a group of university Nursing students about vaccines, as well as their sources of information and their education needs. A cross-sectional study was performed through a questionnaire (55 items) provided to Nursing students at two Spanish universities. A total of 1122 students participated in the study. The mean score obtained for knowledge about vaccines was 44.6 ± 4.3, and for attitudes towards vaccines, it was 37.2 ± 3.9. Hepatitis B (94.7%) and the Flu (89%) are the two main vaccines they should receive as health workers. The main source of information was the family environment (65.6%). Most of them considered that post-graduate education about vaccines should be provided by academic entities (universities, 62.7%). Among the health professionals, Nurses (85.5%) must be better educated and trained on the subject of vaccines. It is therefore necessary to delve into and complete the nurses’ training on vaccines, to educate them about the risks at the individual level, and their decisive role as promoters of the vaccination strategy for the general population. Universities must become the leaders in vaccine education and training.
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Affiliation(s)
- José Tuells
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, San Vicente del Raspeig, 03690 Alicante, Spain;
- Correspondence: ; Tel.: +34-965-903838
| | - Cecilia M. Egoavil
- Unit of Clinical Pharmacology, Alicante University General Hospital, 03010 Alicante, Spain; (C.M.E.); (C.S.-G.)
| | - Isabel Morales-Moreno
- Department of Nursing, Universidad Católica San Antonio de Murcia (UCAM) Campus de los Jerónimos, N. 135 Guadalupe, 30107 Murcia, Spain;
| | - Elena Fortes-Montoya
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, San Vicente del Raspeig, 03690 Alicante, Spain;
| | - Carlos Salazar-García
- Unit of Clinical Pharmacology, Alicante University General Hospital, 03010 Alicante, Spain; (C.M.E.); (C.S.-G.)
| | - Noelia Rodríguez-Blanco
- Department of Obstetrics and Gynaecology, Marina Baixa University Hospital, Av. Alcalde En Jaume Botella Mayor, 7, 03570 Villajoyosa, Spain;
- Department of Nursing, Universidad Cardenal Herrera-CEU, Plaza Reyes Católicos, 19, 03204 Elche, Spain
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11
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Privor-Dumm L. Determinants of policy and uptake of national vaccine programs for pregnant women: results of mixed method study from Spain, Italy, and India. Hum Vaccin Immunother 2020; 17:1474-1482. [PMID: 33215935 PMCID: PMC8078648 DOI: 10.1080/21645515.2020.1831858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
An important strategy for addressing maternal and newborn risks of disease is through vaccinating pregnant women. We conducted a mixed-methods study including a narrative literature review of drivers of maternal vaccination and key informant interviews in Spain, Italy, and India to characterize different approaches to national maternal immunization programs. Fifty-nine respondents participated in the study conducted between November 2018 and January 2019. Policies in Spain and Italy both reflect a life-course approach to vaccination, but recommendations and how they ensure uptake differs. Italy was focused on tracking of progress and mandates to ensure compliance in all regions, while Spain, an early adopter, relied more on advocacy and building provider acceptance. India includes Td in their national program, but the political will and advocacy for other vaccines are not seen. Needs for improving rates of maternal vaccination include education of health-care providers and pregnant women, use of central registries to track progress, stronger global guidance for use of vaccines, and engagement of champions, particularly obstetrician-gynecologists (ob-gyns). Health security concerns can also be leveraged to build political priority and needed platforms to detect disease and deliver vaccines in some countries. Understanding what drives a country’s maternal immunization program decisions and the success of implementation is useful in designing strategies to share best practices and guide support to strengthen platforms for maternal vaccination.
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Affiliation(s)
- Lois Privor-Dumm
- International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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12
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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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Vila-Candel R, Martín A, Escuriet R, Castro-Sánchez E, Soriano-Vidal FJ. Analysis of Caesarean Section Rates Using the Robson Classification System at a University Hospital in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051575. [PMID: 32121364 PMCID: PMC7084406 DOI: 10.3390/ijerph17051575] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 02/20/2020] [Accepted: 02/26/2020] [Indexed: 12/18/2022]
Abstract
Background: The WHO recommends the use of the Robson ten-group classification system (RTGCS) as an effective monitoring and analysis tool to assess the use of caesarean sections (CS). The present study aimed to conduct an analysis of births using the RTGCS in La Ribera University Hospital over nine years and to assess the levels and trends of CS births. Methods: Retrospective study between January 1, 2010, and December 31, 2018. All eligible women were allocated in RTGCS to determine the absolute and relative contribution made by each group to the overall CS rate; linear regression and weighted least squares regression analysis were used to analyze trends over time. The risk of CS of women with induced versus spontaneous onset of labor was calculated with an odds ratio (OR) with a 95% CI. Results: 16,506 women gave birth during the study period, 19% of them by CS. Overall, 20.4% of women were in group 1 (nulliparous, singleton cephalic, term, spontaneous labor), 29.4% in group 2 (nulliparous, singleton cephalic, term, induced labor or caesarean before labor), and 12.8% in group 4 (multiparous, singleton cephalic, term, induced or caesarean delivery before labor) made the most significant contributions to the overall rate of CS; Conclusions: In our study, Robson Groups 1, 2, and 4, were identified as the main contributors to the hospital’s overall CS rate. The RTGCS provides an easy way of collecting information about the CS rate, is a valuable clinical method that allows standardized comparison of data, and time point, and identifies the groups driving changes in CS rates.
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Affiliation(s)
- Rafael Vila-Candel
- Department of Obstetrics and Gynaecology, Hospital Universitario de la Ribera, FISABIO. Crta. Corbera km 1, 46600 Valencia, Spain
- Department of Nursing, Faculty of Nursing and Podiatry, Universitat de València, Jaume Roig, s/n, 46010 Valencia, Spain;
- Correspondence:
| | - Anna Martín
- School of Medicine, Universidad Autónoma de Madrid, Spain. C/Arzobispo Morcillo 4, 28029 Madrid, Spain;
- School of Health Sciences Blanquerna, Universitat Ramon Llull, C/Padilla 326, 08025 Barcelona, Spain;
| | - Ramón Escuriet
- School of Health Sciences Blanquerna, Universitat Ramon Llull, C/Padilla 326, 08025 Barcelona, Spain;
| | - Enrique Castro-Sánchez
- NIHR Health Protection Research Unit (HPRU) in Healthcare Associated Infections (HCAI) and Antimicrobial Resistance (AMR) at Imperial College London, Du Cane Road, London W12 0NN, UK;
| | - Francisco Javier Soriano-Vidal
- Department of Nursing, Faculty of Nursing and Podiatry, Universitat de València, Jaume Roig, s/n, 46010 Valencia, Spain;
- Department of Obstetrics and Gynaecology, Hospital Lluis Alcanyis, FISABIO. Crta Xàtiva, s/n, 46800 Valencia, Spain
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Rodríguez-Blanco N, Tuells J. Knowledge and Attitudes about the Flu Vaccine among Pregnant Women in the Valencian Community (Spain). ACTA ACUST UNITED AC 2019; 55:medicina55080467. [PMID: 31405260 PMCID: PMC6723429 DOI: 10.3390/medicina55080467] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 07/31/2019] [Accepted: 08/05/2019] [Indexed: 12/11/2022]
Abstract
Background and Objectives: To describe the knowledge and attitudes related to the acceptance of the flu vaccine during pregnancy in women, from two Health Departments of the Valencian Community (VC), during the 2015–2016 season, after receiving prenatal care. Materials and Methods: A prospective observational study was conducted during the annual vaccine season of women ascribed to prenatal care. A midwife offered flu vaccine advice and afterwards conducted a telephone poll of a representative sample, in order to find out the reason for accepting or rejecting the vaccine. Results: Of the 1017 expectant women who received advice about the vaccine, 77.4% (95% CI: 74.8–79.9%) declared their intention to vaccinate. After the recommendation, the vaccine coverage was 61.6%, with a percentage of accordance of 98.8% (95% CI: 98.0–99.6%) between the coverage declared and the Nominal Vaccination Registry (NVR) of the VC. Additionally, 67.2% of the expectant women were interviewed (n = 683). Most were aware of the recommendation and identified the health center and the midwife as the main sources of information. The internet was a consistent source in favor of vaccination 80.8% (n = 42). The obstetric variables (risk during the pregnancy, end of pregnancy, and feeding the newborn) did not have a statistically significant relationship with the vaccination. The women declared a high adherence to the vaccinations present in the child vaccination calendar, but rejected (31.3%) the flu vaccine, as they had not received it previously and did not want it because of their expectant state. Conclusions: The women positively evaluated the effectiveness and safety of the vaccines. However, with the flu vaccine, “not being previously vaccinated” and the “doubts about its safety” represented more than half of the reasons put forth for its rejection. Ensuring that the flu vaccine is perceived as more effective and acceptable through the messages directed towards the expectant mothers, directly through the midwives or through the communication media and social networks, will result in an increase of vaccine coverage.
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Affiliation(s)
- Noelia Rodríguez-Blanco
- Department of Obstetrics and Gynaecology, Hospital Universitario del Vinalopó, Spain C/Tonico Sansano Mora, 14, 03293 Elche, Spain
- Department of Nursing Universidad CEU Cardenal Herrera. Plaza Reyes Católicos, 19, 03204 Elche, Spain
| | - José Tuells
- Cátedra Balmis de Vacunología. University of Alicante. Campus de San Vicente Raspeig. Ap.99, E-03080 Alicante, Spain.
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