Perinatal Quality Collaborative for Maine, Augusta, Maine.
Midwife Workshops, East Boothbay, Maine.
J Midwifery Womens Health. 2021 May;66(3):308-321. doi: 10.1111/jmwh.13259.
Vaccination is a strategic public health measure designed to reduce the adverse effects of many infectious diseases. Although national recommendations exist for vaccine administration across the life span, immunization rates are affected by barriers to vaccine access and hesitancy in vaccine acceptance. Midwives and women's health clinicians are optimally poised to assess their client's vaccination status and provide vaccinations during clinical encounters. In order to address client concerns about vaccine safety and administration, each clinician is expected to be knowledgeable about vaccine benefits, recommendations, side effects, and potential adverse reactions. Socioeconomic factors, social policies, and historic and continued experiences related to racism have been identified as barriers to ready access to vaccinations and vaccine acceptance. Midwives can act as leaders within their practice sites and communities through participation in projects that reduce barriers to vaccine access and uptake. Community vaccine outreach programs and relationship-based care can increase vaccine uptake through improved health literacy and associated behavioral changes including greater vaccine acceptance. This article focuses on identifying barriers to vaccine uptake and describing harm reduction measures designed to improve uptake of vaccines. A variety of leadership activities are discussed that can improve clinicians' understanding of their role in optimizing vaccination.
疫苗接种是一项战略性的公共卫生措施，旨在减轻许多传染病的不良影响。尽管在整个生命周期中都有国家推荐的疫苗接种建议，但疫苗接种率受到疫苗接种机会的障碍和对疫苗接种的犹豫的影响。助产士和妇女健康临床医生最适合评估其客户的疫苗接种状况，并在临床就诊时提供疫苗接种。为了解决客户对疫苗安全性和接种的担忧，每个临床医生都应该了解疫苗的益处、建议、副作用和潜在的不良反应。已经确定社会经济因素、社会政策以及与种族主义有关的历史和持续经验是获得疫苗和接受疫苗的障碍。助产士可以通过参与减少疫苗接种机会和接种障碍的项目，在其实践场所和社区中充当领导者。社区疫苗外展计划和以关系为基础的护理可以通过提高健康素养和相关行为改变（包括提高疫苗接种接受度）来增加疫苗接种率。本文重点介绍了识别疫苗接种障碍的方法，并描述了旨在提高疫苗接种率的减少伤害措施。讨论了各种领导活动，这些活动可以提高临床医生对其在优化疫苗接种方面的作用的理解。
