Abstract

Recommended vaccinations during pregnancy are safe and can prevent serious illness in both pregnant women and newborns. Despite this, uptake remains low in England. We explored maternal vaccination services at selected maternity sites in London and Liverpool, focusing on service delivery, vaccination recording and midwife training. Services included walk-in vaccination clinics, nurse-led rather than midwife-led vaccination, telephone and text reminders with links to online vaccination booking, multilingual leaflets, posters and digital apps with vaccine information links. However, practical barriers persist. These include poor integration between maternity and primary care data systems for recording vaccinations, limited and inconsistent midwife training, and logistical constraints on vaccine administration. Midwives reported difficulties accessing electronic vaccine records, and vaccination discussions with patients were often absent, particularly in group models of antenatal care. System-level improvements such as integrated data access, protected training time, clear documentation protocols and tailored outreach are needed to strengthen maternal vaccination services.