Razai, MS;
Mansour, R;
Goldsmith, L;
Freeman, S;
Mason-Apps, C;
Ravindran, P;
Kooner, P;
Berendes, S;
Morris, J;
Majeed, A;
et al.
Razai, MS; Mansour, R; Goldsmith, L; Freeman, S; Mason-Apps, C; Ravindran, P; Kooner, P; Berendes, S; Morris, J; Majeed, A; Ussher, M; Hargreaves, S; Oakeshott, P
(2023)
Interventions to increase vaccination against COVID-19, influenza and pertussis during pregnancy: a systematic review and meta-analysis.
J Travel Med, 30 (8).
taad138.
ISSN 1708-8305
https://doi.org/10.1093/jtm/taad138
SGUL Authors: Razai, Mohammad Sharif Ussher, Michael Henry Hargreaves, Sally Oakeshott, Philippa
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Abstract
BACKGROUND: Pregnant women and their babies face significant risks from three vaccine-preventable diseases: COVID-19, influenza and pertussis. However, despite these vaccines' proven safety and effectiveness, uptake during pregnancy remains low. METHODS: We conducted a systematic review (PROSPERO CRD42023399488; January 2012-December 2022 following PRISMA guidelines) of interventions to increase COVID-19/influenza/pertussis vaccination in pregnancy. We searched nine databases, including grey literature. Two independent investigators extracted data; discrepancies were resolved by consensus. Meta-analyses were conducted using random-effects models to estimate pooled effect sizes. Heterogeneity was assessed using the I2 statistics. RESULTS: From 2681 articles, we identified 39 relevant studies (n = 168 262 participants) across nine countries. Fifteen studies (39%) were randomized controlled trials (RCTs); the remainder were observational cohort, quality-improvement or cross-sectional studies. The quality of 18% (7/39) was strong. Pooled results of interventions to increase influenza vaccine uptake (18 effect estimates from 12 RCTs) showed the interventions were effective but had a small effect (risk ratio = 1.07, 95% CI 1.03, 1.13). However, pooled results of interventions to increase pertussis vaccine uptake (10 effect estimates from six RCTs) showed no clear benefit (risk ratio = 0.98, 95% CI 0.94, 1.03). There were no relevant RCTs for COVID-19. Interventions addressed the 'three Ps': patient-, provider- and policy-level strategies. At the patient level, clear recommendations from healthcare professionals backed by text reminders/written information were strongly associated with increased vaccine uptake, especially tailored face-to-face interventions, which addressed women's concerns, dispelled myths and highlighted benefits. Provider-level interventions included educating healthcare professionals about vaccines' safety and effectiveness and reminders to offer vaccinations routinely. Policy-level interventions included financial incentives, mandatory vaccination data fields in electronic health records and ensuring easy availability of vaccinations. CONCLUSIONS: Interventions had a small effect on increasing influenza vaccination. Training healthcare providers to promote vaccinations during pregnancy is crucial and could be enhanced by utilizing mobile health technologies.
Item Type: | Article | |||||||||||||||
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Additional Information: | © International Society of Travel Medicine 2023. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com | |||||||||||||||
Keywords: | Vaccine hesitancy, antenatal care, maternal health, maternal immunization, public policy, strategies, vaccine confidence, Pregnancy, Female, Humans, Influenza, Human, Influenza Vaccines, Whooping Cough, COVID-19, Vaccination, Humans, Whooping Cough, Influenza Vaccines, Vaccination, Pregnancy, Female, Influenza, Human, COVID-19, Vaccine hesitancy, strategies, maternal immunization, vaccine confidence, public policy, antenatal care, maternal health, 1103 Clinical Sciences, 1117 Public Health and Health Services, 1506 Tourism, Tropical Medicine | |||||||||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Infection and Immunity Research Institute (INII) Academic Structure > Population Health Research Institute (INPH) |
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Journal or Publication Title: | J Travel Med | |||||||||||||||
ISSN: | 1708-8305 | |||||||||||||||
Language: | eng | |||||||||||||||
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Publisher License: | Creative Commons: Attribution-Noncommercial 4.0 | |||||||||||||||
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PubMed ID: | 37934788 | |||||||||||||||
Web of Science ID: | WOS:001102125000001 | |||||||||||||||
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URI: | https://openaccess.sgul.ac.uk/id/eprint/115829 | |||||||||||||||
Publisher's version: | https://doi.org/10.1093/jtm/taad138 |
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