Barriers to pertussis jabs in pregnancy: study


monochrome of pregnant belly

A new study has shown the need for better patient information to combat the low uptake of whooping cough vaccine in pregnancy in New Zealand

The research1 from University of Otago and University of Auckland found that most women who had recently been pregnant knew that whooping cough can be dangerous in infants, but many did not know they needed to have the vaccine during pregnancy to protect their infant.

Some of the interviewed women had this vaccination during pregnancy, often on their midwife’s advice.

However, other women did not recall any health professional recommending they should have the vaccine, and a few women were worried about safety of the vaccine in pregnancy.

“Whooping cough is always a risk for babies, but we are due to see another increase in whooping cough in the next couple of years which will increase hospitalisations and risk of deaths in infants,” says lead author Dr Natalie Gauld.

“We needed to find out what the barriers to access were and whether availability in pharmacy could help access.”

Crystal Braganza, one of the researchers who conducted the interviews, noted that “the women who were interviewed were very supportive of having the whooping cough vaccine available in pharmacies. They thought it would help get the message out to pregnant women, and would be convenient to access.”

One region in New Zealand has recently made whooping cough vaccine and influenza vaccine free for pregnant women through pharmacies (in addition to the existing funding in general practice) to try to improve uptake.

Dr Gauld says that “the research suggests that this is a good step in helping to improve awareness of the vaccines and increase convenience for women.

“Pharmacies tend to be open more hours than general practice and can often give the vaccine on the spot without needing an appointment. Pharmacists can also discuss any concerns the woman might have about having the vaccine in pregnancy.”

While the researchers point out that pharmacists can help increase the uptake of vaccines, this was not a finding specific to this study, “possibly because Tdap became available from pharmacists only four months before this study”.

However, they conclude that “widening access to vaccines, for example, through pharmacy availability and encouraging more health professionals to routinely inform pregnant women of current recommendations, may help to address the low rates of pertussis immunisation during pregnancy and the health disparities found in pertussis”.

The research was published in the Journal of Primary Health Care, and used qualitative interviews of women with infants under one year old from around New Zealand.

The last New Zealand epidemic saw 673 babies hospitalised with whooping cough and three babies died.

Research from overseas shows that having vaccines available in pharmacies can help increase the number of people getting vaccinated.

The researchers noted that uptake in Australia is also low.

Pharmacists in NZ who have undergone the approved vaccinator course have been able to administer Tdap vaccine for protection against pertussis since 2014.

  1. Gauld NJ, Braganza CS, Babalola OO, Huynh TT, Hook SM. Reasons for use and non-use of the pertussis vaccine in pregnancy: an interview study in New Zealand women. J Prim Health Care. 2016; 8: 344-50.

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