Public Health Agency, Belfast, Northern Ireland, UK; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.
Public Health Agency, Belfast, Northern Ireland, UK.
Public Health. 2018 Sep;162:111-117. doi: 10.1016/j.puhe.2018.05.025. Epub 2018 Jul 11.
Influenza and pertussis vaccination programmes have been in place for pregnant women in the UK since 2009 and 2012, respectively. In 2015, vaccine uptake rates were 55% for influenza and 63% for pertussis in Northern Ireland. We conducted a qualitative study with the aim of learning about the views of pregnant women and identifying potential barriers to vaccination in pregnancy.
Qualitative study using focus groups and in-depth interviews.
We conducted focus group discussions and interviews on vaccination in pregnancy using a discussion guide developed in consultation with stakeholders and service users. Pregnant women were recruited on-street. We performed inductive coding of transcripts and thematic analysis, using a phenomenological approach.
Sixteen pregnant women participated. We identified six key themes. Information and knowledge: Vaccinated and unvaccinated women demonstrated similar levels of knowledge and desire for information, preferring direct communication with healthcare professionals. The influence of others: Some vaccinated participants reported firm endorsements of vaccination by healthcare professionals including midwives, while some unvaccinated women recalled neutral or reticent staff. Acceptance and trust: Most women expressed trust of health professionals. Fear and distrust: Vaccinated individuals expressed concerns about side-effects more than unvaccinated women. A few unvaccinated women expressed distrust of vaccines and healthcare systems. Responsibility for the baby: Both groups prioritised protecting the baby but unvaccinated participants were concerned about vaccine-related harm. Accessing vaccination: Multiple appointments, lack of childcare, time off work and having responsibility to organise vaccination hindered some participants from getting immunised. Some women were willing to be vaccinated but did not recall being offered vaccination or were not sufficiently motivated to make arrangements themselves.
Healthcare professionals appear to have a vital influential role in pregnant women's decisions about vaccination. Involving midwives and improving convenience of vaccination access may increase uptake. Strategies to develop interventions should address the aforementioned barriers to meet the pregnant women's needs.
自 2009 年和 2012 年以来，英国分别为孕妇推出了流感和百日咳疫苗接种计划。2015 年，北爱尔兰的流感疫苗接种率为 55%，百日咳疫苗接种率为 63%。我们进行了一项定性研究，旨在了解孕妇的观点，并确定怀孕期间疫苗接种的潜在障碍。
使用焦点小组和深入访谈的定性研究。
我们使用与利益相关者和服务使用者协商制定的讨论指南，对怀孕时接种疫苗进行焦点小组讨论和访谈。我们在街上招募孕妇。我们对转录本进行了归纳编码和主题分析，采用了现象学方法。
16 名孕妇参与了研究。我们确定了六个关键主题。信息和知识：已接种和未接种疫苗的女性表现出相似的知识水平和对信息的渴望，更喜欢与医疗保健专业人员进行直接沟通。他人的影响：一些已接种疫苗的参与者报告说，医疗保健专业人员（包括助产士）强烈支持接种疫苗，而一些未接种疫苗的女性则回忆起态度中立或沉默寡言的工作人员。接受和信任：大多数女性对医疗保健专业人员表示信任。恐惧和不信任：已接种疫苗的个体比未接种疫苗的女性更担心副作用。少数未接种疫苗的女性对疫苗和医疗保健系统表示不信任。对婴儿的责任：两组都优先保护婴儿，但未接种疫苗的参与者担心疫苗相关的伤害。接种疫苗的机会：多次预约、缺乏儿童保育、休假和负责组织疫苗接种，这些都阻碍了一些参与者接种疫苗。一些女性愿意接种疫苗，但不记得曾被提供过疫苗接种或没有足够的动力自行安排。
医疗保健专业人员在孕妇对疫苗接种的决策中似乎具有至关重要的影响力。让助产士参与进来并改善接种疫苗的便利性可能会提高接种率。制定干预措施的策略应解决上述障碍，以满足孕妇的需求。
