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Vaccine. 2018 Oct 22;36(44):6473-6479. doi: 10.1016/j.vaccine.2017.08.003. Epub 2017 Aug 12.

Vaccine decision-making begins in pregnancy: Correlation between vaccine concerns, intentions and maternal vaccination with subsequent childhood vaccine uptake.

Author information

1
Vaccine and Immunisation Research Group, Murdoch Childrens Research Institute, Australia; Department of General Medicine, The Royal Children's Hospital, Australia; School of Population and Global Health, The University of Melbourne, Australia. Electronic address: margie.danchin@rch.org.au.
2
Department of General Medicine, The Royal Children's Hospital, Australia.
3
Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Western Australia, Australia; Sir Walter Murdoch School of Public Policy and International Affairs, Murdoch University, Australia.
4
Sydney School of Public Health, Sydney Medical School, University of Sydney, Australia.
5
National Centre for Immunisation Research and Surveillance, Australia.
6
Clinical Epidemiology and Biostatistics Unit, Murdoch Childrens Research Institute, Australia.
7
Sydney School of Public Health, Sydney Medical School, University of Sydney, Australia; National Centre for Immunisation Research and Surveillance, Australia.
8
Vaccine and Immunisation Research Group, Murdoch Childrens Research Institute, Australia; Department of General Medicine, The Royal Children's Hospital, Australia; School of Population and Global Health, The University of Melbourne, Australia.
9
Vaccine and Immunisation Research Group, Murdoch Childrens Research Institute, Australia.
10
The Alfred Hospital, Royal Women's Hospital and Monash Health and Monash University, Australia.
11
Women's and Children's Hospital and Robinson Research Institute, The University of Adelaide, South Australia, Australia.

Abstract

INTRODUCTION:

Maternal and childhood vaccine decision-making begins prenatally. Amongst pregnant Australian women we aimed to ascertain vaccine information received, maternal immunisation uptake and attitudes and concerns regarding childhood vaccination. We also aimed to determine any correlation between a) intentions and concerns regarding childhood vaccination, (b) concerns about pregnancy vaccination, (c) socioeconomic status (SES) and (d) uptake of influenza and pertussis vaccines during pregnancy and routine vaccines during childhood.

METHODS:

Women attending public antenatal clinics were recruited in three Australian states. Surveys were completed on iPads. Follow-up phone surveys were done three to six months post delivery, and infant vaccination status obtained via the Australian Childhood Immunisation Register (ACIR).

RESULTS:

Between October 2015 and March 2016, 975 (82%) of 1184 mothers consented and 406 (42%) agreed to a follow up survey, post delivery. First-time mothers (445; 49%) had significantly more vaccine concerns in pregnancy and only 73% had made a decision about childhood vaccination compared to 89% of mothers with existing children (p-value<0.001). 66% of mothers reported receiving enough information during pregnancy on childhood vaccination. In the post delivery survey, 46% and 82% of mothers reported receiving pregnancy influenza and pertussis vaccines respectively. The mother's degree of vaccine hesitancy and two attitudinal factors were correlated with vaccine uptake post delivery. There was no association between reported maternal vaccine uptake or SES and childhood vaccine uptake.

CONCLUSION:

First time mothers are more vaccine hesitant and undecided about childhood vaccination, and only two thirds of all mothers believed they received enough information during pregnancy. New interventions to improve both education and communication on childhood and maternal vaccines, delivered by midwives and obstetricians in the Australian public hospital system, may reduce vaccine hesitancy for all mothers in pregnancy and post delivery, particularly first-time mothers.

KEYWORDS:

Childhood vaccination; Maternal vaccination; Pregnancy; Vaccine attitudes, behaviours and concerns; Vaccine decision-making; Vaccine uptake

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