Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Apr 2;12(4):857-65.
doi: 10.1080/21645515.2015.1101524.

Improving rates of maternal immunization: Challenges and opportunities

Donna M MacDougall  1   2 , Scott A Halperin  1
Affiliations

Improving rates of maternal immunization: Challenges and opportunities

Donna M MacDougall et al. Hum Vaccin Immunother. .

Abstract

Objectives: An increasing number of vaccines are recommended or are being developed for use during pregnancy to protect women, fetuses, and/or newborns. For vaccines that are already recommended, vaccine uptake is variable and well below desired target. We reviewed the literature related to factors that affect a healthcare provider's recommendation and a woman's willingness to be vaccinated during pregnancy.

Design: A scoping review of published literature from 2005 to 2015 was undertaken and all relevant articles were abstracted, summarized, and organized thematically.

Results: Barriers and facilitators were identified that either decreased or increased the likelihood of a healthcare provider offering and a pregnant woman accepting vaccination during pregnancy. Concern about the safety of vaccines given during pregnancy was the most often cited barrier among both the public and healthcare providers. Other barriers included doubt about the effectiveness of the vaccine, lack of knowledge about the burden of disease, and not feeling oneself to be at risk of the infection. Major facilitators for maternal immunization included specific safety information about the vaccine in pregnant women, strong national recommendations, and healthcare providers who both recommended and provided the vaccine to their patients. Systems barriers such as inadequate facilities and staffing, vaccine purchase and storage, and reimbursement for vaccination were also cited. Evidence-based interventions were few, and included text messaging reminders, chart reminders, and standing orders.

Conclusions: In order to have an effective vaccination program, improvements in the uptake of recommended vaccines during pregnancy are needed. A maternal immunization platform is required that normalizes vaccination practice among obstetrical care providers and is supported by basic and continuing education, communication strategy, and a broad range of research.

Keywords: Barriers; maternal immunization; opportunities.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Supports required for the establishment of a “maternal immunization platform.” HIC: High-income countries; LMIC: Low- and middle-income countries; RSV: Respiratory Syncytial Virus; Tdap: Tetanus, diphtheria, and acellular pertussis vaccine
See this image and copyright information in PMC

References

    1. National Vaccine Advisory Committee . The National Vaccine Advisory Committee: Reducing patient and provider barriers to maternal immunizations. Public Health Rep 2015; 130(1):10-42; PMID:25552752 - PMC - PubMed
    1. Lichty JA, Slavin B, Bradford WL. An attempt to increase resistance to pertussis in newborn infants by immunizing their mothers during pregnancy. J Clin Invest 1938; 17(5):613-21; PMID:16694606; http://dx.doi.org/ 10.1172/JCI100987 - DOI - PMC - PubMed
    1. Adams JM, Kimball AC, Adams FH. Early immunization against pertussis. Am J Dis Child 1947; 74(1):10-8; PMID:20258316; http://dx.doi.org/ 10.1001/archpedi.1947.02030010017002 - DOI - PubMed
    1. Cohen P, Schneck H, Dubow E. Prenatal multiple immunization. J Pediatr 1951; 38(6):696-704; PMID:14841572; http://dx.doi.org/ 10.1016/S0022-3476(51)80131-8 - DOI - PubMed
    1. Schofield FD, Tucker VM, Westbrook GR. Neonatal tetanus in New Guinea. Effect of active immunization in pregnancy. Br Med J 1961; 2(5255):785-9; PMID:13748431; http://dx.doi.org/ 10.1136/bmj.2.5255.785 - DOI - PMC - PubMed

LinkOut - more resources