Influenza and pertussis vaccination in pregnancy: Portrayal in online media articles and perceptions of pregnant women and healthcare professionals

Christopher R Wilcox, Kathryn Bottrell, Pauline Paterson, William S Schulz, Tushna Vandrevala, Heidi J Larson, Christine E Jones, Christopher R Wilcox, Kathryn Bottrell, Pauline Paterson, William S Schulz, Tushna Vandrevala, Heidi J Larson, Christine E Jones

Abstract

Introduction: Online media may influence women's decision to undergo vaccination during pregnancy. The aims of this mixed-methods study were to: (1) examine the portrayal of maternal vaccination in online media and (2) establish the perceived target of vaccine protection as viewed by pregnant women and maternity healthcare professionals (HCPs).

Methods: Online media articles on maternal vaccination (published July-December 2012 or November 2015-April 2016) were identified through the London School of Hygiene & Tropical Medicine's Vaccine Confidence Database and thematically analysed. Questionnaires for pregnant women and HCPs were distributed within four English hospitals (July 2017-January 2018).

Results: Of 203 articles identified, 60% related to pertussis vaccination, 33% to influenza and 6% both. The majority positively portrayed vaccination in pregnancy (97%), but inaccurate, negative articles persist which criticize pertussis vaccination's safety and efficacy. Positively-worded articles about pertussis tended to focus on infant protection and highlight examples of recent cases, whereas positively-worded articles about influenza focused on maternal protection. These themes were reflected in questionnaire responses from 314 pregnant women and 204 HCPs, who perceived pertussis vaccination as protecting the baby, and influenza vaccination as protecting the mother, or mother and baby equally. A minority of the pregnant women surveyed intended to decline influenza (22%) or pertussis (8%) vaccination.

Conclusions: The majority of online articles support pertussis and influenza vaccination during pregnancy. The portrayal of pertussis vaccination as primarily benefiting the child, using real-examples, may influence its higher uptake compared with influenza. This approach should be considered by HCPs when recommending vaccination. HCPs should be prepared to provide advice to women hesitant about vaccination, including addressing any negative media, and consider educational strategies to counteract inaccurate information. Future studies should directly assess the influence of media on vaccine decision-making and establish which media platforms are typically used by pregnant women to gather information.

Trial registration: ClinicalTrials.gov NCT03096574.

Keywords: Confidence; Decision-making; Maternal; Media; Pregnancy; Vaccination.

Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Figures

Fig. 1
Fig. 1
Occurrence of themes in articles regarding influenza and pertussis vaccination in pregnancy between July and December 2012.
Fig. 2
Fig. 2
Occurrence of themes in articles regarding influenza and pertussis vaccination in pregnancy between November 2015 and April 2016.

References

    1. Poehling K.A., Szilagyi P.G., Staat M.A., Snively B.M., Payne D.C., Bridges C.B. Impact of maternal immunization on influenza hospitalizations in infants. Am J Obstet Gynecol. 2011;204:S141–S148.
    1. Amirthalingam G., Andrews N., Campbell H., Ribeiro S., Kara E., Donegan K. Effectiveness of maternal pertussis vaccination in England: an observational study. Lancet. 2014;384:1521–1528.
    1. Zaman K., Roy E., Arifeen S.E., Rahman M., Raqib R., Wilson E. Effectiveness of maternal influenza immunization in mothers and infants. New Engl J Med. 2008;359:1555–1564.
    1. Madhi S.A., Cutland C.L., Kuwanda L., Weinberg A., Hugo A., Jones S. Influenza Vaccination of Pregnant Women and Protection of Their Infants. New Engl J Med. 2014;371:918–931.
    1. Chu Englund. Maternal Immunization. Clin Infect Dis. 2014;59:560–568.
    1. McIntyre P., Wood N. Pertussis in early infancy: disease burden and preventive strategies. Curr Opin Infect Dis. 2009;22:215–223.
    1. Mak T., Mangtani P., Leese J., Watson J., Pfeifer D. Influenza vaccination in pregnancy: current evidence and selected national policies. Lancet Infect Dis. 2008;8:44–52.
    1. Wiley K.E., Massey P.D., Cooper S.C., Wood, Quinn H.E., Leask Pregnant women’s intention to take up a post-partum pertussis vaccine, and their willingness to take up the vaccine while pregnant: a cross sectional survey. Vaccine. 2013;31:3972–3978.
    1. Poland G. Vaccines against Lyme disease: What happened and what lessons can we learn? Clin Infect Dis Off Publ Infect Dis Soc Am. 2011;52(Suppl. 3):s253–s258.
    1. Wilson R.J., Paterson P., Jarrett C., Larson H.J. Understanding factors influencing vaccination acceptance during pregnancy globally: a literature review. Vaccine. 2015;33:6420–6429.
    1. Public Health England. Seasonal influenza vaccine uptake in GP patients: winter season 2016 to 2017; 2017.
    1. Public Health England. Pertussis vaccination programme for pregnant women update: vaccine coverage in England, January to March 2017. Health Protection Report; 2017. p. 11.
    1. Wilson R., Larson H., Paterson P. Understanding factors influencing vaccination acceptance during pregnancy in Hackney, London. Lancet. 2016;388:S112.
    1. Larson H., Jarrett C., Schulz W., Chaudhuri M., Zhou Y., Dube E. Measuring vaccine hesitancy: the development of a survey tool. Vaccine. 2015;33:4165–4175.
    1. Hesse B., Nelson D., Kreps G., Croyle R., Arora N., Rimer B. Trust and sources of health information: the impact of the Internet and its implications for health care providers: findings from the first Health Information National Trends Survey. Arch Intern Med. 2005:2618–2624.
    1. Braun V., Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3:77–101.
    1. Kharbanda E., Vargas C.Y., Castaño P.M., Lara M., Andres R., Stockwell M.S. Exploring pregnant women’s views on influenza vaccination and educational text messages. Prev Med. 2011;52:75–77.
    1. Maher L., Hope K., Torvaldsen S., Lawrence G., Dawson A., Wiley K. Influenza vaccination during pregnancy: coverage rates and influencing factors in two urban districts in Sydney. Vaccine. 2013;31:5557–5564.
    1. Wiley K., Cooper S., Wood N., Leask J. Understanding pregnant women’s attitudes and behavior toward influenza and pertussis vaccination. Qual Health Res. 2014;25:360–370.
    1. Marsh H., Malik F., Shapiro E., Omer S., Frew P. Message framing strategies to increase influenza immunization uptake among pregnant African American women. Matern Child Health J. 2014;18:1639–1647.
    1. Adler S., Finney J., Manganello A., Best A. Prevention of child-to-mother transmission of cytomegalovirus among pregnant women. J Pediat. 2004;145:485–491.
    1. Goldfarb I., Jennewein M., Cosgrove C., Brown J., Krykbaeva M., Cooperrider J. 338: Maternal Tdap: how do antibodies protect newborns against pertussis? Am J Obstet Gynecol. 2017;216:S205–S206.
    1. Gall S., Myers J., Pichichero M. Maternal immunization with tetanus–diphtheria–pertussis vaccine: effect on maternal and neonatal serum antibody levels. Am J Obstet Gynecol. 2011;204:334.e1–334.e5.
    1. Ladhani S.N., Andrews N.J., Southern J., Jones C.E., Amirthalingam G., Waight P.A. Antibody responses after primary immunization in infants born to women receiving a pertussis-containing vaccine during pregnancy: single arm observational study with a historical comparator. Clin Infect Dis. 2015;61:1637–1644.
    1. Sim J., Ulanika A., Katikireddi S., Gorman D. “Out of two bad choices, I took the slightly better one”: vaccination dilemmas for Scottish and Polish migrant women during the H1N1 influenza pandemic. Publ Health. 2011;125:505–511.
    1. Donaldson B., Jain P., Holder B., Lindsay B., Regan L., Kampmann B. What determines uptake of pertussis vaccine in pregnancy? A cross sectional survey in an ethnically diverse population of pregnant women in London. Vaccine. 2015;33:5822–5828.
    1. Panda B., Stiller R., Panda A. Influenza vaccination during pregnancy and factors for lacking compliance with current CDC guidelines. J Matern-Fetal Neonat Med. 2011;24:402–406.
    1. Wiley K., Massey P., Cooper S., Wood N., Ho J., Quinn H. Uptake of influenza vaccine by pregnant women: a cross-sectional survey. Med J Australia. 2013;198:373–375.
    1. Baxter D. Approaches to the vaccination of pregnant women: experience from Stockport, UK, with prenatal influenza. Hum Vacc Immunother. 2013;9:1360–1363.
    1. Kriss J., Frew P., Cortes M., Malik F., Chamberlain A., Seib K. Evaluation of two vaccine education interventions to improve pertussis vaccination among pregnant African American women: a randomized controlled trial. Vaccine. 2017;35:1551–1558.
    1. Unknown. MatImms: a smartphone app to inform and educate women about maternal immunisation 10AD.
    1. Gazmararian J.A., Elon L., Yang B., Graham M., Parker R. Text4baby program: an opportunity to reach underserved pregnant and postpartum women? Matern Child Health J. 2014;18:223–232.
    1. Keelan J., Pavri-Garcia V., Tomlinson G., Wilson K. YouTube as a source of information on immunization: a content analysis. JAMA. 2007:2482–2484.
    1. Ford A., Alwan N. Use of social networking sites and women’s decision to receive vaccinations during pregnancy: a cross-sectional study in the UK. Vaccine. 2018
    1. Goldfarb I., Little S., Brown J., Riley L. Use of the combined tetanus-diphtheria and pertussis vaccine during pregnancy. Am J Obstet Gynecol. 2014;211:299.e1–299.e5.
    1. Dempsey A., Brewer S., Sevick C., Pyrzanowski J., Mazzoni S., O’Leary S. Tdap vaccine attitudes and utilization among pregnant women from a high-risk population. Hum Vacc Immunother. 2016;12:872–878.
    1. Harris K., Maurer J., Lurie N. Do people who intend to get a flu shot actually get one? J Gen Intern Med. 2009;24:1311–1313.
    1. Mangtani P., Shah A., Roberts J. Validation of influenza and pneumococcal vaccine status in adults based on self-report. Epidemiol Infect. 2007;135:139–143.

Source: PubMed

3
Subskrybuj