Amirthalingam G, Andrews N, Campbell H, Ribeiro S, Kara E, Donegan K, K Fry NK, Miller E, Ramsay M Effectiveness of maternal pertussis vaccination in England: an observational study. Lancet. 2014; 384:(9953)1521-8

Beel ER, Rench MA, Montesinos DP, Mayes B, Healy CM Knowledge and attitudes of postpartum women toward immunization during pregnancy and the peripartum period. Hum Vaccin Immunother. 2013; 9:(9)1926-31

Blanchard-Rohner G, Meier S, Bel M, Combescure C, Othenin-Girard V, Swali RA, Martinez de Tejada B, Siegrist CA Influenza vaccination given at least 2 weeks before delivery to pregnant women facilitates transmission of seroprotective influenza-specific antibodies to the newborn. Pediatr Infect Dis J. 2013; 32:(12)1374-80

Blencowe H, Lawn J, Vandelaer J, Roper M, Cousens S Tetanus toxoid immunization to reduce mortality from neonatal tetanus. Int J Epidemiol. 2010; 39:i102-9

Chief Medical Officer. Temporary Programme Of Pertussis (Whooping Cough) Vaccination Of Pregnant Women. 2012. (accessed 16 July 2015)

Dabrera G, Amirthalingam G, Andrews N A case-control study to estimate the effectiveness of maternal pertussis vaccination in protecting newborn infants in England and Wales, 2012–2013. Clin Infect Dis. 2014; 60:(3)333-7

Department of Health. Market research. 2015. (accessed 2 July 2015)

Influenza Vaccination Coverage Among Pregnant Women — United States, 2013–14 Influenza Season. 2014. (accessed 2 July 2015)

Donegan K, King B, Bryan P Safety of pertussis vaccination in pregnant women in the UK: observational study. BMJ. 2014; 349

Eppes C, Wu A, Cameron KA, Garcia P, Grobman W Does obstetrician knowledge regarding influenza increase HINI vaccine acceptance among their pregnant patients?. Vaccine. 2012; 30:(39)5782-4

European Centre of Disease Prevention and Control. ECDC TECHNICAL REPORT. Seasonal influenza vaccination in Europe. Overview of vaccination recommendations and coverage rates in the EU Member States for the 2012–13 influenza season. 2015. (accessed 16 July 2015)

London: HPA; 2005

Ishola DA, Permalloo N, Cordery RJ, Anderson SR Midwives' influenza vaccine uptake and their views on vaccination of pregnant women. J Public Health. 2013; 35:(4)570-7

Keller-Stanislawski B, Englund JA, Kang G, Mangtani P, Neuzile K, Nohynek H, Pless R, Lambach P, Zuber P Safety of immunization during pregnancy: A review of the evidence of selected inactivated and live attenuated vaccines. Vaccine. 2014; 32:(52)7057-64

Kennedy ED, Ahluwalia IB, Ding H, Lu PJ, Singleton JA, Bridges CB Monitoring seasonal influenza vaccination coverage among pregnant women in the United States. Am J Obstet Gynecol. 2012; 207:(3 Suppl)9-16

Knight M, Kenyon S, Brocklehurst P, Neilson J, Shakespeare J, Kurinczuk JJOxford: National Perinatal Epidemiology Unit, University of Oxford; 2014

National Readership Survey. Social Grade. 2014. (accessed 16 July 2015)

Office for National Statistics. Ethnicity and National Identity in England and Wales 2011. 2012. (accessed 8 May 2015)

Omer SB, Goodman D, Steinhoff MC, Rochat R, Klugman KP, Stoll BJ, Ramakrishnan U Maternal influenza immunization and reduced likelihood of prematurity and small for gestational age births: a retrospective cohort study. PLoS Med. 2011; 8:(5)

Public Health England. Laboratory-confirmed cases of pertussis reported to the enhanced pertussis surveillance programme in 2012. 2013a. (accessed 8 May 2015)

Pertussis Vaccination Programme for Pregnant Women: Vaccine coverage estimates in England, October 2012 to September 2013. Health Protection Report. 2013b; 7:50-1

Public Health England and Department of Health. Continuation of whooping cough vaccination programme in pregnancy advised. 2014. (accessed 8 May 2015)

Pertussis Vaccination Programme for Pregnant Women: vaccine coverage estimates in England, September to December 2014. Health Protection Report. 2015a; 8

Public Health England. PHE Weekly National Influenza Report Summary of UK surveillance of influenza and other seasonal respiratory illnesses. 7 May 2015 – Week 19 report (up to week 18 data). 2015b. (accessed 8 May 2015)

Regan A, Tracey L, Blythe CC A prospective cohort study comparing the reactogenicity of trivalent influenza vaccine in pregnant and non-pregnant women. BMC Pregnancy Childbirth. 2015; 15

Robbins SC, Leask J, Hayles EH, Sinn JK Midwife attitudes: an important determinant of maternal postpartum pertussis booster vaccination. Vaccine. 2011; 29:(34)5591-4

Tamma PD, Ault KA, del Rio C, Steinhoff MC, Halsey NA, Omer SB Safety of influenza vaccination during pregnancy. Am J Obstet Gynecol. 2009; 201:(6)547-52

Wiley KE, Massey PD, Cooper SC, Wood NJ, Ho J, Quinn HE, Leask J Uptake of influenza vaccine by pregnant women: a cross-sectional survey. Med J Aust. 2013a; 198:(7)373-5

Wiley KE, Massey PD, Cooper SC, Wood N, Quinn HE, Leask J Pregnant women's intention to take up a post-partum pertussis vaccine, and their willingness to take up the vaccine while pregnant: a cross sectional survey. Vaccine. 2013b; 31:(37)3972-8

Vaccines against influenza WHO position paper–November 2012. Weekly epidemiological record. 2012; 47:(87)461-76

Attitudes to immunisation in pregnancy among women in the UK targeted by such programmes

02 August 2015
Volume 23 · Issue 8



Vaccines in pregnancy can minimise diseases with associated high morbidity and mortality in pregnant women, their unborn and newly born infants. Immunisations against influenza and pertussis are routinely offered in pregnancy in a number of countries including the UK, US, Australia and Belgium, but vaccine uptake could be improved.


In January 2013, an online survey of pregnant women and women with children under 2 years of age was undertaken. The survey focused on vaccination in pregnancy.

Results and conclusions:

Of 1892 respondents, the majority indicated they definitely, or probably, would accept a nationally-approved vaccine offered by their midwife or GP during pregnancy for their own protection (94%) and/or to protect their baby when it was born (96%). Vaccine safety for the baby and for the woman, vaccine effectiveness and perceived seriousness of the disease remain key considerations for women. Health professionals, midwives in particular, are pivotal in informing women, promoting the vaccine and discussing concerns.

The ability to safely and effectively vaccinate in pregnancy offers important protection to both pregnant women and their babies in utero and from birth against potentially serious infectious diseases. In developed countries, however, there is a perceived reluctance for pregnant women to take up immunisation as a preventive intervention. This is not surprising given the general advice that some medicines in pregnancy can be harmful ( Thus confident and knowledgeable professionals, who are able to provide information and immunisations to these women, are key to the success of such programmes.

Pertussis (whooping cough) immunisation for all pregnant women was recommended as an outbreak control measure in England from October 2012 following the declaration by Public Health England (PHE, previously the Health Protection Agency) of a pertussis outbreak earlier that year (Chief Medical Officer, 2012). In 2012, the highest recorded pertussis incidence for over 15 years was seen with 14 deaths in babies too young to be protected by infant vaccination (PHE, 2013a). The pregnancy programme has been extended until at least 2019 on the advice of the national independent expert advisory committee, the Joint Committee on Vaccination and Immunisation (JCVI) (PHE and Department of Health (DH), 2014). In the current UK programme, the pertussis vaccine is ideally offered between weeks 28 and 32 of pregnancy; and may be offered up to 38 weeks gestation. Pertussis immunisation is recommended routinely for all pregnant women in a number of countries including the USA, New Zealand, Belgium, several South American countries and Australia. However, national vaccine coverage has not been published in these countries.

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • New content and clinical newsletter updates each month