Attitudes to immunisation in pregnancy among women in the UK targeted by such programmes
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 (www.nhs.uk/Conditions/pregnancy-and-baby/Pages/medicines-in-pregnancy.aspx). 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.
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