Use of social networking sites and women's decision to receive vaccinations during pregnancy: A cross-sectional study in the UK.

In the UK, it is recommended that pregnant women receive the influenza and pertussis vaccination. However, uptake of these vaccinations in certain UK regions remains low. Previous studies show that pregnant women use the internet to access health information, yet it has not been previously explored whether the use of social networking sites (SNS) influences decisions about maternal vaccination uptake. The aim of this study was to determine, if the use of SNS to gain information on pregnancy vaccinations, is associated with women's uptake of the influenza and pertussis vaccines during pregnancy. This is a cross-sectional study with data collected using an online questionnaire posted on Mumsnet (an online parenting site), from 3rd to 24th August 2017. Women were included if they lived in the UK, were over 32 weeks pregnant, or had given birth in the last year. Participants were questioned about their pregnancy vaccination uptake, general SNS use and, their SNS use in relation to gathering information on vaccinations during pregnancy. The data was analysed using chi-square test, and univariable and multivariable logistic regression. Out of a sample of 308 participants, 305 (99.3%) of women reported using SNS and 64/308 (20.8%) of women reported using SNS to gather information on vaccinations during pregnancy. Women who reported using SNS to gather information on pregnancy vaccinations were 58% (adjusted odds ratio 0.42; 95% CI 0.21-0.87) less likely to receive the pertussis vaccination during pregnancy. However, the association was not statistically significant for the influenza vaccination (adjusted odds ratio 0.64; 95% CI 0.37-1.11). The study showed many women use SNS to gather information on pregnancy vaccinations, and this is negatively associated with their likelihood of receiving the pertussis vaccine. Future studies are needed to analyse the accuracy and quality of the vaccination information, which women find on SNS.

Ford AJ ，Alwan NA 《-》

Cross-sectional study on factors associated with influenza vaccine uptake and pertussis vaccination status among pregnant women in Germany.

Pregnant women and their newborns are at increased risk for influenza-related complications; the latter also have an increased risk for pertussis-related complications. In Germany, seasonal influenza vaccination is recommended for pregnant women since 2010. A dose of pertussis-containing vaccine has been recommended since 2004 for women of childbearing age if they have not been vaccinated within the past 10 years. We conducted a nationwide cross-sectional survey among pregnant women in February/March 2013 to assess knowledge, attitudes, and practices related to influenza vaccination during pregnancy and to identify factors associated with their pertussis vaccination status. In total, 1025 pregnant women participated and provided information through a self-administered questionnaire. Of these, 23.2% were vaccinated against seasonal influenza during the 2012/13 season; 15.9% during their pregnancy. Major reasons for being unvaccinated (n=686 respondents) were lack of confidence in the vaccine (60.4%) and the perception that vaccination was not necessary (40.3%). Influenza vaccination during pregnancy was independently associated with having received influenza vaccine in the previous season, having received a recommendation from a physician, a high level of vaccine-related knowledge and of perceived disease severity. In contrast, knowledge of the recommendation for regular hand-washing to prevent influenza and the perception that vaccine-related side effects were likely to occur or likely to be severe were negatively associated with vaccine uptake. Receipt of a pertussis vaccine in the past 10 years was reported by 22.5% of participants. Pertussis vaccine uptake was independently associated with living in the Eastern federal states and receiving seasonal influenza vaccination annually, while a migration background was associated with a lower uptake. To enhance vaccine uptake in pregnant women and women of childbearing age, special efforts must be undertaken to improve knowledge of both recommendations and the benefits of vaccination. Gynecologists could serve as important facilitators.

Bödeker B ，Walter D ，Reiter S ，Wichmann O ... -  《-》

Influence of health literacy on acceptance of influenza and pertussis vaccinations: a cross-sectional study among Spanish pregnant women.

Immunisations against influenza and Bordetella pertussis infection are recommended to pregnant women in Valencia (Spain), yet vaccination rates remain low. Health literacy (HL) appears as a crucial factor in vaccination decision-making. We explored the relation between HL of pregnant women and decisions to receive influenza and pertussis immunisations. University hospital in Valencia (Spain). 119 women who gave birth at a hospital in Valencia (Spain) between November 2015 and May 2016. Women in the immediate postpartum period (more than 27 weeks of gestation), between November 2015 and May 2016 were included in the study. Women with impairments, language barriers or illiteracy which prevented completion of the questionnaires, or those who were under 18 years were excluded from enrolment. HL level; influenza and pertussis immunisation rate; reasons for rejection of vaccination. 119 participants were included (mean age 32.3±5.5 years, 52% primiparous, 95% full-term deliveries). A higher education level was associated with Short Assessment of Health Literacy for Spanish Adults _50 (adjusted R2=0.22, p=0.014) and Newest Vital Sign (adjusted R2=0.258, p=0.001) scores. Depending on the scale, 56%-85% of participants had adequate HL. 52% (62/119) and 94% (112/119) of women received influenza and pertussis immunisation, respectively. Women rejecting influenza vaccine had a higher HL level (measured by SALHSA_50 tool) than those accepting it (Kruskal-Wallis test p=0.022). 24% of women who declined influenza vaccination felt the vaccine was unnecessary, and 23% claimed to have insufficient information. Influenza vaccination rate was suboptimal in our study. Women with high HL were more likely to decline immunisation. Information from professionals needs to match patients' HL levels to reduce negative perceptions of vaccination.

Castro-Sánchez E ，Vila-Candel R ，Soriano-Vidal FJ ，Navarro-Illana E ，Díez-Domingo J ... -  《-》

Psychosocial determinants of pertussis and influenza vaccine uptake in pregnant women: A prospective study.

To identify the psychosocial factors influencing women's uptake and willingness to receive pertussis and influenza vaccine during pregnancy. The study population comprised 1364 healthy nulliparous pregnant women who participated in a prospective cohort study at two obstetric hospitals in South Australia between 2015 and 2017. Information on women's vaccination status, sociodemographic, lifestyle and psychological state were collected at 9-16 weeks' gestation and medical case notes were checked post-delivery to verify the reported vaccination status. Poisson regression models were used to estimate the crude and adjusted prevalence ratios (aPRs) to identify psychosocial factors influencing uptake of vaccination during pregnancy. Willingness to receive the recommended maternal vaccines was high (90%). Overall, 79% and 48% received maternal pertussis and influenza vaccines respectively. There was no evidence to support the influence of psychosocial factors on women's willingness to receive immunization during pregnancy. High levels of anxiety (aPR 0.98, 95% CI: 0.87-1.09) was not associated with uptake of maternal pertussis vaccine. However, elevated depressive symptoms (aPR 1.14, 95% CI: 1.00-1.30) and very high-perceived stress during pregnancy were significantly associated with receipt of pertussis vaccination (aPR 0.87; 95% CI 0.76-0.99). Women with mild depressive symptoms (aPR 1.21, 95% CI 1.00-1.44) and mild anxiety symptoms (aPR 1.21, 95% CI: 0.99-1.48) were more likely to receive influenza vaccine during pregnancy (aPR 1.27, 95% CI: 1.08-1.49). A history of major depressive disorder was independently associated with receipt of pertussis (aPR 1.16, 95% CI 1.06-1.26) and influenza vaccination during pregnancy (aPR 1.32; 95% CI 1.14-1.58). Regardless of psychosocial factors, most women reported a positive willingness to receive the recommended vaccinations during pregnancy. However, psychosocial factors influenced the uptake of pertussis and influenza vaccines during pregnancy. Psychosocial factors should be taken into consideration in designing interventions and implementation of maternal pertussis and influenza immunization programs.

Mohammed H ，Roberts CT ，Grzeskowiak LE ，Giles L ，Leemaqz S ，Dalton J ，Dekker G ，Marshall HS ... -  《-》

Understanding the barriers to uptake of antenatal vaccination by women from culturally and linguistically diverse backgrounds: A cross-sectional study.

Krishnaswamy S ，Cheng AC ，Wallace EM ，Buttery J ，Giles ML ... -  《-》