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. 2022 Jan 20;10(2):150.
doi: 10.3390/vaccines10020150.

Increasing Uptake of Maternal Pertussis Vaccinations through Funded Administration in Community Pharmacies

Anna S Howe  1   2 , Natalie J Gauld  3   4 , Alana Y Cavadino  5 , Helen Petousis-Harris  1 , Felicity Dumble  6 , Owen Sinclair  7 , Cameron C Grant  3   8
Affiliations

Increasing Uptake of Maternal Pertussis Vaccinations through Funded Administration in Community Pharmacies

Anna S Howe et al. Vaccines (Basel). .

Abstract

Although maternal pertussis vaccination is recommended, uptake is suboptimal in New Zealand (NZ), despite full funding in general practice and hospitals. We determined whether funding maternal pertussis vaccination in community pharmacy increases its uptake. Pertussis vaccination during pregnancy was compared between non-contiguous, demographically similar regions of NZ. The pertussis vaccine was funded at pharmacies from Nov 2016 in one NZ region (Waikato), but not in comparator regions (Northland, Hawkes Bay). Vaccinations during pregnancy were determined from the National Immunisation Register, general practice and pharmacy claims data, and a maternity database. Comparisons were made using adjusted odds ratios (OR) and 95% confidence intervals (CI) for Nov 2015 to Oct 2016 versus Nov 2016 to Oct 2019. The odds of pregnancy pertussis vaccination increased in the post-intervention versus pre-intervention period with this increase being larger (p = 0.0014) in the intervention (35% versus 21%, OR = 2.07, 95% CI 1.89-2.27) versus the control regions (38% versus 26%, OR = 1.67, 95% CI 1.52-1.84). Coverage was lower for Māori versus non-Māori, but increased more for Māori in the intervention versus control regions (117% versus 38% increase). It was found that funding maternal pertussis vaccination in pharmacy increases uptake, particularly for Māori women. Measures to increase coverage should include reducing barriers to vaccines being offered by non-traditional providers, including pharmacies.

Keywords: immunisation; pharmacists; pregnancy; vaccination; vaccination coverage.

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Conflict of interest statement

N.G. was a member of the National Executive of the Pharmaceutical Society of New Zealand during the research and has received funding from Green Cross Health (a provider of primary health care services including pharmacy and general practice), the Pharmacy Guild of New Zealand and the Pharmaceutical Society of New Zealand for reclassifying vaccinations to allow pharmacist administration. H.P.H. has participated in expert advisory boards to the GSK group of companies, Merck, and Pfizer but has not personally received honorarium. She has also led investigator-led studies funded by the GSK group of companies. C.C.G. was a member of the Immunisation Subcommittee of the Pharmacology and Therapeutics Advisory Committee 2012–2019. He is a named investigator on this project and has been an investigator on other GSK group of companies funded vaccination related projects. A.S.H. has been involved in work funded by the GSK group of companies in addition to this work. O.S. has no conflicts to report other than the GSK group of companies funding for this project. A.Y.C. and F.D. have no conflicts to report. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Participant Flow Chart. 1 Counts may not necessarily add up as an individual may have multiple exclusion criteria. 2 Entirety of 28–38 weeks’ gestational period must be entirely within the pre-intervention period or entirely with the post-intervention period.
Figure 2
Figure 2
Percentage change in pertussis coverage for pregnant women between pre- and post-intervention periods, by the District Health Board (dark bands are the study regions, Waikato is the intervention region and Hawke’s Bay and Northland the control regions).
Figure 3
Figure 3
Date of maternal pertussis vaccination in the intervention region, as a proportion administered by pharmacy versus traditional providers.
Figure 4
Figure 4
Date of maternal pertussis vaccination in the intervention region, by provider. The drop in vaccination from Sep. 2016 to Feb. 2017 and at the end of the intervention period reflects the requirement to count only women who were weeks 28–38 entirely in the pre-intervention or the post-intervention period.
See this image and copyright information in PMC

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