Direction des risques biologiques et de la santé au travail, Institut national de la santé publique du Québec, Eve Dubé, 2400 D'Estimauville, Québec, QC, G1E 7G9, Canada.
Axe maladies infectieuses et immunitaires, Centre de recherche du CHU de Québec -Université Laval, Quebec City, Qc, Canada.
BMC Pregnancy Childbirth. 2022 Jun 13;22(1):477. doi: 10.1186/s12884-022-04809-6.
In Canada, vaccination against pertussis (Tdap) during pregnancy has been recommended since 2018, with suboptimal uptake. We aimed to assess the determinants of intention and uptake of Tdap vaccine among pregnant women in Quebec.
Participants (< 21 weeks of pregnancy) were recruited in four Quebec regions. Two online surveys were administered during pregnancy (< 21 weeks and > 35 weeks). One measured vaccination intention and the other assessed the actual decision. Questionnaires were informed by the Theory of Planned Behaviour (TPB). We used logistic multivariate analysis to identify determinants of Tdap vaccination uptake during pregnancy using responses to both questionnaires.
A total of 741 women answered the first survey and 568 (76.7%), the second survey. In the first survey most participants intended to receive the Tdap vaccine during their pregnancy (76.3%) and in the second survey, 82.4% reported having been vaccinated against Tdap during their pregnancy. In multivariate analysis, the main determinants of vaccine uptake were: a recommendation from a healthcare provider (OR = 7.6), vaccine intention (OR = 6.12), social norms (or thinking that most pregnant women will be vaccinated (OR = 3.81), recruitment site (OR = 3.61 for General Family Medicine unit) perceived behavioral control (or low perceived barriers to access vaccination services, (OR = 2.32) and anticipated feeling of guilt if not vaccinated (OR = 2.13). Safety concerns were the main reason for not intending or not receiving the vaccine during pregnancy.
We observed high vaccine acceptance and uptake of pertussis vaccine in pregnancy. The core components of the TPB (intention, social norms and perceived behavioral control) were all predictors of vaccine uptake, but our multivariate analysis also showed that other determinants were influential: being sufficiently informed about Tdap vaccination, not having vaccine safety concerns, and anticipated regret if unvaccinated. To ensure high vaccine acceptance and uptake in pregnancy, strong recommendations by trusted healthcare providers and ease of access to vaccination services remain instrumental.
在加拿大，自 2018 年以来，已建议孕妇接种百日咳（Tdap）疫苗，但接种率仍不理想。我们旨在评估魁北克省孕妇接种 Tdap 疫苗的意愿和接种情况的决定因素。
参与者（<21 周妊娠）在魁北克的四个地区招募。在妊娠期间（<21 周和>35 周）进行了两次在线调查。一项调查测量了疫苗接种意愿，另一项调查评估了实际决策。调查问卷由计划行为理论（TPB）提供信息。我们使用逻辑多元分析，根据两次调查问卷的回答，确定怀孕期间接种 Tdap 疫苗的决定因素。
共有 741 名妇女回答了第一次调查，568 名（76.7％）回答了第二次调查。在第一次调查中，大多数参与者打算在怀孕期间接种 Tdap 疫苗（76.3％），在第二次调查中，82.4％的人报告在怀孕期间接种了 Tdap 疫苗。在多元分析中，疫苗接种的主要决定因素是：医疗保健提供者的建议（OR=7.6）、疫苗接种意愿（OR=6.12）、社会规范（或认为大多数孕妇将接种疫苗（OR=3.81）、招募地点（OR=3.61 为一般家庭医学单位）、感知行为控制（或感知接种疫苗服务的障碍较低（OR=2.32）以及如果未接种疫苗，预计会感到内疚（OR=2.13）。对安全性的担忧是不打算或不接受怀孕期间接种疫苗的主要原因。
我们观察到怀孕期间对百日咳疫苗的高度接受和接种。TPB 的核心组成部分（意图、社会规范和感知行为控制）都是疫苗接种的预测因素，但我们的多元分析还表明，其他决定因素也有影响：对 Tdap 疫苗接种有足够的了解、没有疫苗安全问题、如果未接种疫苗，预计会感到后悔。为了确保怀孕期间疫苗的高接受率和高接种率，仍需要医疗保健提供者的大力推荐和方便获取疫苗接种服务。
