Sauer Molly A, Fesshaye Berhaun, Miller Emily S, Schue Jessica L, Singh Prachi, Jalang'o Rose, Nyiro Joyce, Karanja-Chege Christine, Njogu Rosemary, Were Fred, Karron Ruth A, Limaye Rupali J
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
National Vaccines and Immunization Program, Ministry of Health, Nairobi, Kenya.
PLOS Glob Public Health. 2025 Aug 28;5(8):e0004505. doi: 10.1371/journal.pgph.0004505. eCollection 2025.
Maternal vaccination, or vaccination in pregnancy, offers a critical opportunity to provide protection to pregnant women and simultaneously confer passive immunity to infants in the first months of life, when infections are particularly serious and their immune systems are still developing. Respiratory syncytial virus (RSV) is one such serious infectious disease for newborns, but a newly approved and recommended vaccine for respiratory syncytial virus has been designed to be given to pregnant women to protect their newborns from severe RSV disease when they are most vulnerable. While maternal vaccination has been used for tetanus, pertussis, influenza, COVID-19, and other diseases, vaccination in pregnancy can present unique challenges related to hesitancy and delivery, particularly in lower-resourced settings. Using data from a cross-sectional survey of 400 pregnant and lactating women in Nakuru and Mombasa Counties in Kenya, we examined perspectives related to maternal vaccination and RSV. We conducted a latent class analysis on 12 dichotomized knowledge, attitude, and belief items and then examined factors associated with class membership using a binary logistic regression. We identified two distinct archetypes among study subjects, maternal vaccine "questioners" and maternal vaccine "acceptors." There was a notable difference in perceived vaccination-enabling social norms between "questioners" and "acceptors," and participants using private health facilities were more likely to be in the "questioner" class compared to those using public facilities (aOR: 2.99, 95% CI: 1.32-6.77). This respondent-driven approach to identify groups that may require different communication strategies can help to shape efforts to target preparations for future RSV vaccine introduction in Kenya. Recognizing that "questioners" accounted for nearly one in four participants, these learnings can help to inform tailored health promotion strategies to support informed, confident maternal vaccination decision-making among providers, communities, and pregnant women and mitigate vaccination hesitancy and refusal.
孕产妇疫苗接种，即在孕期进行疫苗接种，为保护孕妇并同时在婴儿生命的最初几个月赋予其被动免疫力提供了一个关键契机，因为在这几个月里，感染尤其严重，而婴儿的免疫系统仍在发育。呼吸道合胞病毒（RSV）就是一种对新生儿来说如此严重的传染病，但一种新批准并推荐使用的呼吸道合胞病毒疫苗被设计用于给孕妇接种，以在新生儿最脆弱的时候保护他们免受严重的呼吸道合胞病毒疾病侵害。虽然孕产妇疫苗接种已用于破伤风、百日咳、流感、新冠病毒及其他疾病，但孕期接种疫苗可能会带来与犹豫态度和接种实施相关的独特挑战，尤其是在资源较少的环境中。利用对肯尼亚纳库鲁县和蒙巴萨县400名孕妇和哺乳期妇女进行的横断面调查数据，我们研究了与孕产妇疫苗接种及呼吸道合胞病毒相关的观点。我们对12个二分的知识、态度和信念项目进行了潜在类别分析，然后使用二元逻辑回归研究了与类别归属相关的因素。我们在研究对象中确定了两种不同的原型，即孕产妇疫苗“质疑者”和孕产妇疫苗“接受者”。“质疑者”和“接受者”在感知到的有助于疫苗接种的社会规范方面存在显著差异，与使用公共卫生设施的参与者相比，使用私立卫生设施的参与者更有可能属于“质疑者”类别（调整后比值比：2.99, 95%置信区间：1.32 - 6.77）。这种由受访者驱动的方法来识别可能需要不同沟通策略的群体，有助于为肯尼亚未来引入呼吸道合胞病毒疫苗的准备工作提供针对性努力。认识到“质疑者”占近四分之一的参与者，这些研究结果有助于为制定量身定制的健康促进策略提供信息，以支持医疗服务提供者、社区和孕妇做出明智、自信的孕产妇疫苗接种决策，并减轻疫苗接种犹豫和拒绝现象。
