Abstract
Objective
We aimed to understand pregnant women's perceptions of vaccination during pregnancy
and to assess their reaction to different vaccine messages.
Study Design
English-speaking pregnant women aged 18 years or older who received prenatal care
at a safety-net hospital participated in qualitative interviews. Interview topics
included attitudes toward vaccinations in general and toward influenza and tetanus–diphtheria–pertussis
vaccination in pregnancy. Participants were also queried regarding sources of vaccine
information, and were asked to provide feedback on specific messages regarding maternal
vaccination.
Results
Twenty-eight pregnant women participated in interviews. Participant age ranged from
18 to 40 years old; 64% were insured through Medicaid. All participants had positive
attitudes toward routine vaccinations and had received vaccinations for themselves
and their children. Attitudes were less favorable for influenza vaccines than other
vaccines. Participants reported receiving vaccine information from multiple sources.
Stories about vaccine harms worried participants, even when they did not trust the
sources of negative information. All stated that their health care providers were
the most trusted source of information. Participants felt that the most important
messages to encourage maternal vaccination were that maternal vaccination protects
the baby after birth and maternal vaccination is safe for both mother and baby. Participants
were not motivated to vaccinate by messages about the severity of maternal disease.
Conclusions
Maternal vaccinations are important to protect pregnant women and infants from influenza
and pertussis. Focusing on messages related to vaccine safety and protection of the
infant are motivating to mothers, especially when delivered by trusted health care
providers.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Women's Health IssuesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Summary: Maternal Immunization.Obstetrics and Gynecology. 2018; 131: 1188-1191
- Qualitative analysis of mothers’ decision-making about vaccines for infants: The importance of trust.Pediatrics. 2006; 117: 1532-1541
- Skewed risk perceptions in pregnant women: The case of influenza vaccination.BMC Public Health. 2015; 16: 1308
- why maternal vaccines are important.(Available:)www.cdc.gov/vaccines/pregnancy/hcp-toolkit/important-maternal-vaccines.htmlDate: 2017Date accessed: April 1, 2020
- Factors associated with intention to receive influenza and tetanus, diphtheria, and acellular pertussis (Tdap) vaccines during pregnancy: A focus on vaccine hesitancy and perceptions of disease severity and vaccine safety.PLoS Currents. 2015; 7
- Constructing grounded theory: A practical guide through qualitative analysis.Sage, Thousand Oak, CA2006
- Increased awareness and health care provider endorsement is required to encourage pregnant women to be vaccinated.Human Vaccines & Immunotherapeutics. 2014; 10: 2922-2929
- Decision-making on maternal pertussis vaccination among women in a vaccine-hesitant religious group: Stages and needs.PloS One. 2020; 15: e0242261
- Tdap vaccine attitudes and utilization among pregnant women from a high-risk population.Human Vaccines & Immunotherapeutics. 2016; 12: 872-878
- Effect of a health care professional communication training intervention on adolescent human papillomavirus vaccination: A cluster randomized clinical trial.JAMA Pediatrics. 2018; 172: e180016
- Associations between exposure to and expression of negative opinions about human papillomavirus vaccines on social media: An observational study.Journal of Medical Internet Research. 2015; 17: e144
- The qualitative content analysis process.Journal of Advanced Nursing. 2008; 62: 107-115
- Indicated or elective? The association of providers’ words with HPV vaccine receipt.Human Vaccines & Immunotherapeutics. 2018; : 1-7
- Vaccination persuasion online: A qualitative study of two provaccine and two vaccine-skeptical websites.Journal of Medical Internet Research. 2015; 17: e133
- Factors that influence uptake of vaccination in pregnancy.Irish Medical Journal. 2018; 111: 713
- Factors associated with seasonal influenza vaccination in pregnant women.Journal of Women’s Health (2002). 2015; 24: 394-402
- Understanding the barriers to uptake of antenatal vaccination by women from culturally and linguistically diverse backgrounds: A cross-sectional study.Human Vaccines & Immunotherapeutics. 2018; 14: 1591-1598
- Influenza and pertussis vaccination coverage in pregnant women.Vaccine. 2015; 33: 2125-2131
- Improving rates of maternal immunization: Challenges and opportunities.Human Vaccines & Immunotherapeutics. 2016; 12: 857-865
- Codebook development for team-based qualitative analysis.Field Methods. 1998; 10: 31-36
- Stories about HPV vaccine in social media, traditional media, and conversations.Preventive Medicine. 2019; 118: 251-256
- Factors associated with uptake of influenza and pertussis vaccines among pregnant women in South Australia.PloS One. 2018; 13: e0197867
- Predictors of maternal vaccination in the United States: An integrative review of the literature.Vaccine. 2016; 34: 3942-3949
- Effective messages in vaccine promotion: A randomized trial.Pediatrics. 2014; 133: e835-e842
- Why do low-income minority parents choose human papillomavirus vaccination for their daughters?.J Pediatr. 2010; 157: 617-622
- Misinformation lingers in memory: Failure of three pro-vaccination strategies.PloS One. 2017; 12: e0181640
- Provider recommendation mediates the relationship between parental human papillomavirus (HPV) vaccine awareness and HPV vaccine initiation and completion among 13- to 17-year-old U.S. adolescent children.Clinical Pediatrics. 2015; 54: 371-375
- Effects of influenza on pregnant women and infants.American Journal of Obstetrics and Gynecology. 2012; 207: S3-8
- Influenza and Tdap vaccination coverage among pregnant women—United States, April 2020.MMWR. Morbidity and Mortality Weekly Report. 2020; 69: 1391-1397
- Social learning theory and the Health Belief Model.Health Education Quarterly. 1988; 15: 175-183
- Predictors of HPV vaccine uptake among women aged 19-26: Importance of a physician’s recommendation.Vaccine. 2010; 29: 890-895
- Insurance status and vaccination coverage among US preschool children.Pediatrics. 2004; 113: 1959-1964
- Effectiveness of maternal pertussis vaccination in preventing infection and disease in infants: The NSW Public Health Network case-control study.Vaccine. 2018; 36: 1887-1892
- Infant hospitalizations and mortality after maternal vaccination.Pediatrics. 2018; 14 1
- Ten threats to global health in 2019.2019 (Available:)www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019Date accessed: April 1, 2020
- Effectiveness of maternal influenza immunization in mothers and infants.New England Journal of Medicine. 2008; 359: 1555-1564
Biography
Taylor L. Fuss, MD, MPH, Boston University School of Medicine. Dr. Fuss has an interest in pediatrics and vaccinations.
Biography
Jean L. Devera, BS, Boston University School of Medicine. Mr. Devera has an interest in pediatrics and vaccinations.
Biography
Natalie Pierre-Joseph, MD, MPH, Boston University School of Medicine. Dr. Pierre-Joseph is a pediatrician with a longstanding interest in vaccinations and health equity.
Biography
Rebecca B. Perkins, MD, MSc, Boston University School of Medicine. Dr. Perkins is an obstetrician-gynecologist with a longstanding interest in vaccinations and health equity.
Article info
Publication history
Published online: October 08, 2021
Accepted:
September 15,
2021
Received in revised form:
September 1,
2021
Received:
April 8,
2021
Footnotes
Funding: Suzanne Cutler Vaccination Education & Research Fund at the Boston University School of Medicine.
No authors have relevant conflicts of interest to declare.
Identification
Copyright
© 2021 Jacobs Institute of Women's Health, George Washington University. Published by Elsevier Inc. All rights reserved.
