Division of Health Sciences , Kōhatu-Centre for Hauora Māori, Otago Medical School, University of Otago, PO Box 56 , 9054, Dunedin, New Zealand.
Department of Public Health, School of Public Health and Interdisciplinary Studies, Auckland University of Technology, Auckland, New Zealand.
BMC Health Serv Res. 2022 Jun 14;22(1):779. doi: 10.1186/s12913-022-08162-4.
Maternal vaccinations for influenza and pertussis are recommended in New Zealand to protect mothers and their infant from infection. However, maternal immunisation coverage in New Zealand is suboptimal. Furthermore, there is unacceptable inequitable maternal immunisation rates across the country with Māori and Pacific women having significantly lower maternal immunisation rates than those of other New Zealanders.
This research set out to explore what pregnant/recently pregnant Māori and Pacific women knew about immunisation during pregnancy and what factors influenced their decision to be vaccinated. A semi-structured interview guide was developed with questions focusing on knowledge of pertussis and influenza vaccination during pregnancy and decision-making. Māori and Pacific women aged over 16 years were purposively sampled and interviewed in Dunedin and Gisborne, New Zealand between May and August 2021. Interviews were analysed following a directed qualitative content approach. Data were arranged into coding nodes based on the study aims (deductive analysis) informed by previous literature and within these participant experiences were inductively coded into themes and subthemes.
Not all women were aware of maternal vaccine recommendations or they diseases they protected against. Many underestimated how dangerous influenza and pertussis could be and some were more concerned about potential harms of the vaccine. Furthermore, understanding potential harms of infection and protection provided by vaccination did not necessarily mean women would choose to be vaccinated. Those who decided to vaccinate felt well-informed, had vaccination recommended by their healthcare provider, and did so to protect their and their infant's health. Those who decided against vaccination were concerned about safety of the vaccines, lacked the information they needed, were not offered the vaccine, or did not consider vaccination a priority.
There is a lack of understanding about vaccine benefits and risks of vaccine-preventable diseases which can result in the reinforcement of negative influences such as the fear of side effects. Furthermore, if vaccine benefits are not understood, inaccessibility of vaccines and the precedence of other life priorities may prevent uptake. Being well-informed and supported to make positive decisions to vaccinate in pregnancy is likely to improve vaccine coverage in Māori and Pacific Island New Zealanders.
新西兰建议孕妇接种流感和百日咳疫苗，以保护母亲及其婴儿免受感染。然而，新西兰的孕产妇免疫接种覆盖率并不理想。此外，全国各地的孕产妇免疫接种率存在不可接受的不平等现象，毛利人和太平洋岛民妇女的孕产妇免疫接种率明显低于其他新西兰人。
本研究旨在探讨孕妇/近期孕妇对怀孕期间免疫接种的了解程度，以及影响她们接种疫苗决定的因素。在 2021 年 5 月至 8 月期间，在新西兰的达尼丁和吉斯伯恩，使用重点关注怀孕期间百日咳和流感疫苗接种和决策的半结构化访谈指南对年龄在 16 岁以上的毛利人和太平洋岛民妇女进行了有针对性的抽样和访谈。采用定向定性内容分析方法对访谈进行分析。根据研究目的（演绎分析），将数据安排到编码节点中，这些目的受到了先前文献的启发，在这些节点中，根据参与者的经验归纳出主题和子主题。
并非所有妇女都了解孕产妇疫苗推荐或它们所预防的疾病。许多人低估了流感和百日咳的危险性，有些人更担心疫苗的潜在危害。此外，了解感染的潜在危害和疫苗接种提供的保护并不一定意味着妇女会选择接种疫苗。那些决定接种疫苗的人感到消息灵通，得到了医疗保健提供者的推荐，并这样做是为了保护自己和婴儿的健康。那些决定不接种疫苗的人担心疫苗的安全性、缺乏所需的信息、未获得疫苗接种机会、或认为疫苗接种不是优先事项。
对疫苗益处和疫苗可预防疾病的风险缺乏了解，可能导致对副作用等负面因素的强化。此外，如果不了解疫苗的益处，疫苗的可及性和其他生活优先事项的优先级可能会阻止接种。知情并得到支持以做出积极的接种决定，可能会提高新西兰毛利人和太平洋岛民的疫苗接种覆盖率。
