Psychosocial determinants of pertussis and influenza vaccine uptake in pregnant women: A prospective study |
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| Institution: | 1. Vaccinology and Immunology Research Trials Unit, Women''s and Children''s Hospital, Adelaide, South Australia, Australia;2. Robinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia;3. Northern Campus Women''s and Children''s Division, Lyell McEwin Hospital, The University of Adelaide, Elizabeth Vale, South Australia, Australia;1. School of Public Health and Community Medicine, University of New South Wales, Sydney, NSW, Australia;2. National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Kids Research Institute, Children''s Hospital at Westmead, NSW, Australia;1. Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, 1000 N Oak Ave, ML2, Marshfield, WI 54449, United States;2. Institute for Health Research, Kaiser Permanente Colorado, 10065 E Harvard Ave #300, Denver, CO 80231, United States;3. Vaccine Study Center, Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612, United States;4. Center for Health Research, Kaiser Permanente Northwest, 3800 N Interstate Ave, Portland, OR 97227, United States;5. Immunization Safety Office, Centers for Disease Control and Prevention, 1600 Clifton Road NE, MS V18-4, Atlanta, GA 30333, United States;1. Groupe d’Étude sur le Risque d’Exposition des Soignants aux agents infectieux (GERES), UFR de Médecine Bichat, 16, rue Henri-Huchard, 75018 Paris, France;2. Hôpital Bichat-Claude-Bernard AP–HP, 46, rue Henri-Huchard, 75018 Paris, France;3. Hôpital Beaujon AP–HP, 100, boulevard du Général-Leclerc, 92110 Clichy, France;4. Centre Hospitalier de la Côte Basque, 13, avenue de l’Interne Jacques Loeb, 64100 Bayonne, France;5. Sous-Groupe Professionnels de santé, Groupe Prévention de la Société Française de Pathologie Infectieuse de Langue Française, 21, rue de Beaurepaire, 75010 Paris, France;6. Hôpital Jean-Verdier AP–HP, avenue du 14 juillet, 93140 Bondy, France;7. CHU de Rouen, 37, boulevard Gambetta, 76000 Rouen, France;1. Vaccinology and Immunology Research Trials Unit, Women''s and Children''s Hospital, North Adelaide, South Australia 5006, Australia;2. School of Medicine, University of Adelaide, South Australia 5006, Australia;3. Previously employed at Vaccinology and Immunology Research Trials Unit, Women''s and Children''s Hospital, North Adelaide, South Australia 5006, Australia;4. School of Public Health, University of Adelaide, South Australia 5005, Australia;5. Robinson Research Institute, University of Adelaide, South Australia 5006, Australia;1. Department of Epidemiology and Population Health, The London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London WC1E 7HT, UK;2. Department of Psychology, University of Essex, Colchester, Essex CO4 3SQ, UK;1. Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás, Brazil;5. Department of Medicine, Division of Infectious Diseases, Rutgers New Jersey Medical School, Newark, NJ, USA |
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| Abstract: | ObjectiveTo identify the psychosocial factors influencing women’s uptake and willingness to receive pertussis and influenza vaccine during pregnancy.MethodsThe study population comprised 1364 healthy nulliparous pregnant women who participated in a prospective cohort study at two obstetric hospitals in South Australia between 2015 and 2017. Information on women's vaccination status, sociodemographic, lifestyle and psychological state were collected at 9–16 weeks’ gestation and medical case notes were checked post-delivery to verify the reported vaccination status. Poisson regression models were used to estimate the crude and adjusted prevalence ratios (aPRs) to identify psychosocial factors influencing uptake of vaccination during pregnancy.ResultsWillingness to receive the recommended maternal vaccines was high (90%). Overall, 79% and 48% received maternal pertussis and influenza vaccines respectively. There was no evidence to support the influence of psychosocial factors on women’s willingness to receive immunization during pregnancy. High levels of anxiety (aPR 0.98, 95% CI: 0.87–1.09) was not associated with uptake of maternal pertussis vaccine. However, elevated depressive symptoms (aPR 1.14, 95% CI: 1.00–1.30) and very high-perceived stress during pregnancy were significantly associated with receipt of pertussis vaccination (aPR 0.87; 95% CI 0.76–0.99). Women with mild depressive symptoms (aPR 1.21, 95% CI 1.00–1.44) and mild anxiety symptoms (aPR 1.21, 95% CI: 0.99–1.48) were more likely to receive influenza vaccine during pregnancy (aPR 1.27, 95% CI: 1.08–1.49). A history of major depressive disorder was independently associated with receipt of pertussis (aPR 1.16, 95% CI 1.06–1.26) and influenza vaccination during pregnancy (aPR 1.32; 95% CI 1.14–1.58).ConclusionRegardless of psychosocial factors, most women reported a positive willingness to receive the recommended vaccinations during pregnancy. However, psychosocial factors influenced the uptake of pertussis and influenza vaccines during pregnancy. Psychosocial factors should be taken into consideration in designing interventions and implementation of maternal pertussis and influenza immunization programs. |
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| Keywords: | Maternal immunization Pertussis Influenza Psychosocial factors Provider recommendation |
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