School of Nursing, Allied and Public Health, Faculty of Health, Science, Social Care and Education, Kingston University London, London, United Kingdom.
Centre for Neonatal and Paediatric Infection and Vaccine Institute, St George's, University of London, London, United Kingdom.
PLoS One. 2024 Oct 30;19(10):e0312799. doi: 10.1371/journal.pone.0312799. eCollection 2024.
Vaccination during pregnancy is an important healthcare intervention for safeguarding the health of the mother and their infants. Ethnic disparities in recruitment to vaccine research studies during pregnancy potentially contribute to health inequalities. The aim of the current study was to explore the barriers and enablers influencing the willingness of pregnant women from ethnic minority backgrounds to participate in vaccine research studies.
Semi-structured qualitative online interviews were conducted with 23 pregnant women from diverse ethnic backgrounds in the UK. Interviews were transcribed verbatim, and thematically analysed. Our findings suggest that participants perceived vaccines and vaccine research, in principle, to be beneficial to the individual and to society, and understood the value of vaccination in mitigating severity of disease and protecting the health of mothers and their infants. Apprehension over the safety of vaccination in pregnancy was common and reduced willingness to participate. For those that decided to participate in vaccine trials in pregnancy, this was seen as an act of solidarity, a way to contribute to a collective responsibility for the public health of the community. Personal and community connections and representation-seeing people from their own communities represented in in the recruitment process shapped decisions about vaccine trial participating. Trust and mistrust in health systems, shaped by past experiences of interacting with healthcare professionals were likely to inform whether they would consider participating. Practical considerations such as excessive time commitments related to study procedures, travel and organising childcare were barrier to participation. The level of invasiveness of trial procedures were also a concern, although increased monitoring during the trial was seen as a potential benefit, mitigating some safety concerns.
Our study reinforcing previously identified barriers to vaccine participation among pregnant women from diverse ethnic communities. This study underlines the need to develop tailored interventions that focus on fostering trust with the aid of community engagement to understand cultural contexts, establishing authentic representation, and address practical considerations, to contribute to enhancing vaccine trial participation in pregnancy in those from diverse ethnic communities.
孕期接种疫苗是保障母婴健康的重要医疗干预措施。在孕期疫苗研究招募中存在种族差异，这可能导致健康不平等。本研究旨在探讨影响少数族裔背景孕妇参与疫苗研究意愿的障碍和促进因素。
对英国 23 名来自不同族裔背景的孕妇进行了半结构化的在线定性访谈。访谈逐字记录，并进行主题分析。我们的研究结果表明，参与者普遍认为疫苗和疫苗研究原则上对个人和社会都有益，理解接种疫苗在减轻疾病严重程度和保护母婴健康方面的价值。对孕期接种疫苗安全性的担忧普遍存在，降低了参与意愿。对于那些决定参与孕期疫苗试验的人来说，这被视为一种团结的行为，是为社区公共卫生承担集体责任的一种方式。个人和社区的联系和代表性——在招募过程中看到自己社区的人代表，影响了他们对参与疫苗试验的决定。对卫生系统的信任和不信任，受与医疗保健专业人员互动的过往经历影响，可能会影响他们是否考虑参与。与研究程序相关的过度时间承诺、旅行和安排儿童保育等实际问题是参与的障碍。试验程序的侵入性水平也是一个关注点，尽管在试验期间增加监测被认为是潜在的好处，可以减轻一些安全担忧。
本研究进一步证实了先前在不同族裔孕妇中发现的疫苗接种障碍。本研究强调需要制定有针对性的干预措施，通过社区参与来建立信任，了解文化背景，建立真实的代表性，并解决实际问题，以促进不同族裔社区孕妇参与疫苗试验。
