Vaccination in pregnancy: Challenges and evidence-based solutions

Best Pract Res Clin Obstet Gynaecol. 2021 Oct:76:83-95. doi: 10.1016/j.bpobgyn.2021.03.008. Epub 2021 Mar 22.

Abstract

Vaccination in pregnancy (VIP) is dually beneficial - it protects the mother and the baby from tetanus, influenza, and pertussis. VIP uptake is low in many countries. Vaccine hesitancy, defined by the World Health Organization (WHO) as a "delay in acceptance or refusal of vaccination despite the availability of vaccination services" is one of WHO's ten threats to global health per 2019. According to extensive research, mostly from high-income countries (HIC) and limited to tetanus, influenza and pertussis vaccines, lack of provider recommendations, safety concerns, and limitations in access are the main barriers to VIP. Health care provider recommendation is the leading facilitator for VIP across various socioeconomic status groups. Data on strategies to overcome patient, provider, and system barriers to VIP are inconsistent, contradictory, or lacking. Patient-focused research on evidence-based strategies to overcome provider and system barriers is needed. Furthermore, VIP programs require embedded continuous quality improvement to ensure sustainability.

Keywords: Health knowledge, attitudes, practice; Immunization; Immunization programs; Implementation science; Pregnancy; Vaccination.

Publication types

  • Review

MeSH terms

  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Personnel
  • Humans
  • Influenza Vaccines*
  • Influenza, Human* / prevention & control
  • Pregnancy
  • Vaccination
  • World Health Organization

Substances

  • Influenza Vaccines