Winslade C G, Heffernan C M, Atchison C J
NHS England (London Region), 4th Floor, Southside, 105 Victoria Street, London, SW1E 6QT, UK.
NHS England (London Region), 4th Floor, Southside, 105 Victoria Street, London, SW1E 6QT, UK.
Public Health. 2017 May;146:10-14. doi: 10.1016/j.puhe.2016.12.018. Epub 2017 Feb 1.
In 2012, a pertussis outbreak prompted a national vaccination programme for pregnant women, which provides passive protection for infants. Vaccine uptake in London is consistently lower than elsewhere in the UK. There are few studies looking at the reasons why pregnant women accept or refuse pertussis vaccination. Therefore, this study aimed to gain a better understanding of London women's views and experiences, to identify how services might be improved.
Cross-sectional qualitative semi-structured interviews study.
Purposive sampling of four London boroughs was made, taking boroughs in different geographical locations, with varying levels of deprivation and pertussis vaccine uptake. Participants were recruited through baby clinics and interviews conducted covering knowledge about pertussis, the vaccine, information given during pregnancy, factors influencing decision-making, experience of vaccination, future intentions in another pregnancy and recommendations for improving uptake. A thematic analysis approach was used.
A total of 42 interviews were conducted. Five main themes were identified: (1) lack of discussion about pertussis; (2) desire to protect the baby; (3) trust in health professionals; (4) convenience of vaccination; and (5) help navigating 'busyness of pregnancy'. This study found that, if offered, most women would accept vaccination. Although vaccination through the general practitioner was convenient, more options for vaccination, such as through antenatal clinics, might increase uptake. Despite usage of the internet to look up medical information, women wanted to discuss vaccination with their midwives or general practitioners. Women wanted a simple pregnancy 'checklist' to help ensure that they had received all recommended aspects of antenatal care including vaccination.
Poor uptake of vaccine is not always due to lack of demand or active refusals. Service providers have an important role to play in actively promoting vaccination services, ensuring women have access to the information they require and in increasing the availability and access to vaccination programmes.
2012年，一场百日咳疫情促使英国开展了针对孕妇的全国性疫苗接种计划，该计划可为婴儿提供被动保护。伦敦的疫苗接种率一直低于英国其他地区。很少有研究探讨孕妇接受或拒绝百日咳疫苗接种的原因。因此，本研究旨在更好地了解伦敦女性的观点和经历，以确定如何改进服务。
横断面定性半结构式访谈研究。
对伦敦四个行政区进行了立意抽样，选取了地理位置不同、贫困程度和百日咳疫苗接种率各异的行政区。通过母婴诊所招募参与者，并进行访谈，内容涵盖对百日咳、疫苗的了解，孕期获得的信息，影响决策的因素，接种疫苗的经历，再次怀孕时的未来打算以及对提高接种率的建议。采用了主题分析法。
共进行了42次访谈。确定了五个主要主题：（1）缺乏关于百日咳的讨论；（2）保护婴儿的愿望；（3）对医护人员的信任；（4）接种疫苗的便利性；（5）应对“孕期忙碌”的帮助。本研究发现，如果提供疫苗接种服务，大多数女性会接受。虽然通过全科医生接种疫苗很方便，但更多的接种选择，如通过产前诊所接种，可能会提高接种率。尽管女性会使用互联网查找医疗信息，但她们希望与助产士或全科医生讨论疫苗接种问题。女性希望有一个简单的孕期“清单”，以帮助确保她们接受了包括疫苗接种在内的所有推荐的产前护理方面。
疫苗接种率低并不总是由于需求不足或主动拒绝。服务提供者在积极推广疫苗接种服务、确保女性能够获得所需信息以及增加疫苗接种计划的可及性方面发挥着重要作用。
