CVA, London, UK.
Sanofi Pasteur, 14, Espace Henry Vallée, 69007, Lyon, France.
BMC Public Health. 2021 Nov 29;21(1):2182. doi: 10.1186/s12889-021-12198-2.
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.
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.
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.
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.
百日咳和季节性流感可导致孕产妇、新生儿和婴儿发病率和死亡率显著上升，但孕妇接种百白破（破伤风、白喉、无细胞百日咳 [Tdap] 疫苗）和季节性流感疫苗的覆盖率（VCR）仍普遍较低。仅有少数几个国家，包括西班牙、英国（UK）和美国（US），孕妇 Tdap 和季节性流感 VCR 较高。本研究旨在确定促成这些国家高 VCR 的关键因素。
通过三步法，记录了西班牙、英国和美国 Tdap 和季节性流感疫苗接种计划的经验。文献综述产生了 157 篇出版物，通过案头研究又选择了 117 篇文献。修改了一个已发表的五支柱流感 VCR 框架，以评估导致孕妇 Tdap 和季节性流感高 VCR 的具体促成因素。
分析确定了在西班牙、英国和美国三个不同医疗体系中，导致孕妇 VCR 较高的因素。每个国家的几种关键干预措施相结合，导致 VCR 迅速增加，在短短几年内达到接近最佳水平（即季节性流感为 75%）。除了纳入国家免疫计划和疫苗报销外，确定的关键组成部分还包括卫生当局、产前保健医疗保健专业人员（HCP）和科学协会的动员、将疫苗接种纳入产前医疗指导、向 HCP 提供教育材料以及由每个国家最近百日咳疫情引起的强烈疾病意识。
尽管提高低 VCR 没有简单、通用的解决方案，但本研究从三个 Tdap 和季节性流感疫苗接种计划表现良好的国家中确定的组成部分清单为其他国家的公共卫生和医疗利益相关者提供了基础，以确定成功实施国家孕妇疫苗接种计划的策略。
