Perspectives on Maternal Vaccination from Obstetrical Clinicians: A Qualitative Multi-site Study.
Immunization
Influenza
Maternal immunization
Prenatal care
Journal
Maternal and child health journal
ISSN: 1573-6628
Titre abrégé: Matern Child Health J
Pays: United States
ID NLM: 9715672
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
accepted:
09
09
2022
pubmed:
1
11
2022
medline:
16
12
2022
entrez:
31
10
2022
Statut:
ppublish
Résumé
Despite the seriousness of influenza and pertussis, availability of safe and effective vaccines against them, and long-standing maternal vaccination recommendations, US maternal influenza and Tdap vaccination rates have been low. To increase vaccination rates in obstetric offices, it is important to understand clinician perspectives and office processes. We conducted in-depth interviews with nurses and providers on these topics. Interviewees worked in obstetric offices in one-of-four participating health systems in NY and CA. We audio-recorded and transcribed 20-30-min interviews. We used predetermined categories to code interviews with Dedoose, then iteratively refined codes and identified themes. We conducted 20 interviews between 4/2020 and 9/2020: 13 providers (physician or nurse midwife) (5 NY, 8 CA); 7 office nurses (6 NY, 1 CA). In almost all offices, patient refusal of influenza vaccine was considered the major vaccination barrier; Tdap was often deferred by patients until post-delivery. Nurse-only visits for either vaccine were rare. Vaccination outside the office was uncommon; few offices systematically documented vaccines given elsewhere in a retrievable manner. Participants emphasized patient education as key to prenatal care, but the number of topics left little time for immunizations. Few interviewees could identify an office "immunization champion," knew their office vaccination rates, or had participated in vaccination quality improvement. Several interviewees indicated that they or another provider were good at persuading hesitant patients, but their method had not been shared with other clinicians. Multiple practical barriers and maternal vaccine hesitancy limit maternal vaccination. Quality improvement strategies are needed.
Identifiants
pubmed: 36315315
doi: 10.1007/s10995-022-03535-x
pii: 10.1007/s10995-022-03535-x
pmc: PMC9628390
doi:
Substances chimiques
Influenza Vaccines
0
Diphtheria-Tetanus-acellular Pertussis Vaccines
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2506-2516Subventions
Organisme : CDC HHS
ID : CDC 1U01P001114
Pays : United States
Organisme : CDC HHS
ID : CDC 1U01P001114
Pays : United States
Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Ault, K. A., Heine, R. P., & Riley, L. E. (2012). Programmatic and research priorities for improving influenza immunization of pregnant women. American Journal of Obstetrics and Gynecology, 207(3), S75–S77. https://doi.org/10.1016/j.ajog.2012.06.078
doi: 10.1016/j.ajog.2012.06.078
Baxter, R., Bartlett, J., Fireman, B., Lewis, E., & Klein, N. P. (2017). Effectiveness of vaccination during pregnancy to prevent infant pertussis. Pediatrics, 139(5), e20164091. https://doi.org/10.1542/peds.2016-4091
doi: 10.1542/peds.2016-4091
Bisset, K. A., & Paterson, P. (2018). Strategies for increasing uptake of vaccination in pregnancy in high-income countries: A systematic review. Vaccine, 36(20), 2751–2759. https://doi.org/10.1016/j.vaccine.2018.04.013
doi: 10.1016/j.vaccine.2018.04.013
Centers for Disease Control and Prevention. (2013). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) in pregnant women—Advisory Committee on Immunization Practices (ACIP), 2012. Morbidity and Mortality Weekly Report, 62(7), 131–135.
Centers for Disease Control and Prevention. (2021). 2019 Final Pertussis Surveillance Report. Retrieved August 18, 2022, from https://www.cdc.gov/pertussis/downloads/pertuss-surv-report-2019-508.pdf
Chung, Y., Schamel, J., Fisher, A., & Frew, P. M. (2017). Influences on immunization decision-making among US parents of young children. Maternal and Child Health Journal, 21(12), 2178–2187. https://doi.org/10.1007/s10995-017-2336-6
doi: 10.1007/s10995-017-2336-6
Community Preventive Services Task Force. (2022). The community guide: Vaccination. Retrieved August 18, 2022, from https://www.thecommunityguide.org/topic/vaccination
Ellingson, M. K., Dudley, M. Z., Limaye, R. J., Salmon, D. A., O’Leary, S. T., & Omer, S. B. (2019). Enhancing uptake of influenza maternal vaccine. Expert Review of Vaccines, 18(2), 191–204.
doi: 10.1080/14760584.2019.1562907
Frew, P. M., Randall, L. A., Malik, F., Limaye, R. J., Wilson, A., O’Leary, S. T., Salmon, D., Donnelly, M., Ault, K., Dudley, M. Z., Fenimore, V. L., & Omer, S. B. (2018). Clinician perspectives on strategies to improve patient maternal immunization acceptability in obstetrics and gynecology practice settings. Human Vaccines & Immunotherapeutics, 14(7), 1548–1557. https://doi.org/10.1080/21645515.2018.1425116
doi: 10.1080/21645515.2018.1425116
Goodman, K., Mossad, S. B., Taksler, G. B., Emery, J., Schramm, S., & Rothberg, M. B. (2015). Impact of video education on influenza vaccination in pregnancy. The Journal of Reproductive Medicine, 60(11–12), 471–479.
Grohskopf, L. A., Alyanak, E., Broder, K. R., Blanton, L. H., Fry, A. M., Jernigan, D. B., & Atmar, R. L. (2020). Prevention and control of seasonal influenza with vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2020–21 Influenza Season. MMWR Recommendations and Reports, 69(8), 1–24. https://doi.org/10.15585/mmwr.rr6908a1
doi: 10.15585/mmwr.rr6908a1
Hofstetter, A. M., Simon, T. D., Lepere, K., Ranade, D., Strelitz, B., Englund, J. A., & Opel, D. J. (2018). Parental vaccine hesitancy and declination of influenza vaccination among hospitalized children. Hospital Pediatrics, 8(10), 628–635. https://doi.org/10.1542/hpeds.2018-0025
doi: 10.1542/hpeds.2018-0025
Hsieh, H.-F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9), 1277–1288. https://doi.org/10.1177/1049732305276687
doi: 10.1177/1049732305276687
Kempe, A., Saville, A. W., Albertin, C., Zimet, G., Breck, A., Helmkamp, L., Vangala, S., Dickinson, L. M., Rand, C., Humiston, S., & Szilagyi, P. G. (2020). Parental hesitancy about routine childhood and influenza vaccinations: A national survey. Pediatrics, 146(1), e20193852. https://doi.org/10.1542/peds.2019-3852
doi: 10.1542/peds.2019-3852
Lindley, M. C., Kahn, K. E., Bardenheier, B. H., D’Angelo, D. V., Dawood, F. S., Fink, R. V., Havers, F., & Skoff, T. H. (2019). Vital signs: Burden and prevention of influenza and pertussis among pregnant women and infants—United States. MMWR Morbidity and Mortality Weekly Report, 68(40), 885–892. https://doi.org/10.15585/mmwr.mm6840e1
doi: 10.15585/mmwr.mm6840e1
McClure, C. C., Cataldi, J. R., & O’Leary, S. T. (2017). Vaccine hesitancy: Where we are and where we are going. Clinical Therapeutics, 39(8), 1550–1562. https://doi.org/10.1016/j.clinthera.2017.07.003
doi: 10.1016/j.clinthera.2017.07.003
Mertz, D., Geraci, J., Winkup, J., Gessner, B. D., Ortiz, J. R., & Loeb, M. (2016). Pregnancy as a risk factor for severe outcomes from influenza virus infection: A systematic review and meta-analysis of observational studies. Vaccine, 35(4), 521–528. https://doi.org/10.1016/j.vaccine.2016.12.012
doi: 10.1016/j.vaccine.2016.12.012
Mohammed, H., McMillan, M., Roberts, C. T., & Marshall, H. S. (2019). A systematic review of interventions to improve uptake of pertussis vaccination in pregnancy. PLoS ONE, 14(3), e0214538–e0214538. https://doi.org/10.1371/journal.pone.0214538
doi: 10.1371/journal.pone.0214538
Mohanty, S., Carroll-Scott, A., Wheeler, M., Davis-Hayes, C., Turchi, R., Feemster, K., Yudell, M., & Buttenheim, A. M. (2018). Vaccine hesitancy in pediatric primary care practices. Qualitative Health Research, 28(13), 2071–2080. https://doi.org/10.1177/1049732318782164
doi: 10.1177/1049732318782164
Moniz, M. H., Hasley, S., Meyn, L. A., & Beigi, R. H. (2013). Improving influenza vaccination rates in pregnancy through text messaging: A randomized controlled trial. Obstetrics and Gynecology, 121(4), 734–740. https://doi.org/10.1097/AOG.0b013e31828642b1
doi: 10.1097/AOG.0b013e31828642b1
Mouzoon, M. E., Munoz, F. M., Greisinger, A. J., Brehm, B. J., Wehmanen, O. A., Smith, F. A., Markee, J. A., & Glezen, W. P. (2010). Improving influenza immunization in pregnant women and healthcare workers. The American Journal of Managed Care, 16(3), 209–216.
National Vaccine Advisory Committee. (2015). The National Vaccine Advisory Committee: Reducing patient and provider barriers to maternal immunizations. Retrieved August 18, 2022, from https://www.hhs.gov/sites/default/files/nvpo/nvac/reports/nvac_reducing_patient_barriers_maternal_immunizations.pdf
Nunes, M. C., & Madhi, S. A. (2018). Influenza vaccination during pregnancy for prevention of influenza confirmed illness in the infants: A systematic review and meta-analysis. Human Vaccines & Immunotherapeutics, 14(3), 758–766. https://doi.org/10.1080/21645515.2017.1345385
doi: 10.1080/21645515.2017.1345385
Ogburn, T., Espey, E. L., Contreras, V., & Arroyo, P. (2007). Impact of clinic interventions on the rate of influenza vaccination in pregnant women. The Journal of Reproductive Medicine, 52(9), 753–756.
Rand, C. M., Concannon, C., Wallace-Brodeur, R., Davis, W., Albertin, C. S., Humiston, S. G., & Szilagyi, P. G. (2020). Identifying strategies to reduce missed opportunities for HPV vaccination in primary care: A qualitative study of positive deviants. Clinical Pediatrics, 59(12), 1058–1068. https://doi.org/10.1177/0009922820930357
doi: 10.1177/0009922820930357
Razzaghi, H., Kahn, K. E., Black, C. L., Lindley, M. C., Jatlaoui, T. C., Fiebelkorn, A. P., Havers, F. P., D’Angelo, D. V., Cheung, A., Ruther, N. A., & Williams, W. W. (2020). Influenza and Tdap vaccination coverage among pregnant women—United States, April 2020. MMWR Morbidity and Mortality Weekly Report, 69(39), 1391–1397. https://doi.org/10.15585/mmwr.mm6939a2
doi: 10.15585/mmwr.mm6939a2
Shang, M., Blanton, L., Brammer, L., Olsen, S. J., & Fry, A. M. (2018). Influenza-associated pediatric deaths in the United States, 2010–2016. Pediatrics, 141(4), e20172918. https://doi.org/10.1542/peds.2017-2918
doi: 10.1542/peds.2017-2918
Stockwell, M. S., Westhoff, C., Kharbanda, E. O., Vargas, C. Y., Camargo, S., Vawdrey, D. K., & Castaño, P. M. (2014). Influenza vaccine text message reminders for urban, low-income pregnant women: A randomized controlled trial. American Journal of Public Health, 104(Suppl 1), e7–e12. https://doi.org/10.2105/AJPH.2013.301620
doi: 10.2105/AJPH.2013.301620
Szilagyi, P. G., Rand, C. M., McLaurin, J., Tan, L., Britto, M., Francis, A., Dunne, E., Rickert, D., Working Group on Adolescent Vaccination in Medical Home. (2008). Delivering adolescent vaccinations in the medical home: A new era? Pediatrics, 121(Supplement), S15–S24. https://doi.org/10.1542/peds.2007-1115C
doi: 10.1542/peds.2007-1115C
Wong, V. W., Lok, K. Y., & Tarrant, M. (2015). Interventions to increase the uptake of seasonal influenza vaccination among pregnant women: A systematic review. Vaccine, 34(1), 20–32. https://doi.org/10.1016/j.vaccine.2015.11.020
doi: 10.1016/j.vaccine.2015.11.020
Zakrzewski, L., Sur, D. K., & Agrawal, N. (2014). Staff versus physician vaccine protocols for influenza immunization during pregnancy. Journal of the American Board of Family Medicine: JABFM, 27(1), 56–60. https://doi.org/10.3122/jabfm.2014.01.130002
doi: 10.3122/jabfm.2014.01.130002