Integrated approach boosts pertussis vax uptake

monochrome of pregnant belly

A proactive approach to whooping cough vaccination in pregnant women has shown an increase in uptake, say New Zealand researchers – and pharmacies could help

In the central north island of New Zealand, less than half of pregnant women who gave birth in one month in 2017 had their whooping cough booster, the researchers found.

At Rotorua hospital, they undertook a clinical audit using electronic databases to determine pertussis immunisation among the women, between 25 March and 25 April 2017.

They surveyed lead maternity carers to assess knowledge of the vaccine and explore suggestions to increase coverage.

Only 44% (n=49) of the women were vaccinated in 2017, and women aged 25 years and under and those who came from Rotorua were less likely to be among them.

Māori women and women giving birth to their first child were also less likely to be vaccinated, though these differences were not statistically significant.

The biggest factor in not being vaccinated was having not been recalled to the GP for vaccination: every woman in Taupō//Turangi was recalled, and uptake was greater in this area, with only three declining the vaccine and one lost to follow-up after recall.

The researchers noted that Taupo women have access to a greater number of interventions within an integrated healthcare approach.

“Overall, there is a need for more focus on improving delivery of vaccines to young pregnant women,” they wrote.

“The significantly higher rate of pertussis vaccination for women living in Taupo may be due to the way in which multiple healthcare providers bring vaccination to the community, rather than any attempt to bring the women to the vaccine.”

Components of the Taupo program include notifying GPs of pregnancy, finding new ways to promote communication between GPs and LMCs, and vaccinations available in antenatal clinics.

Another is opportunistic vaccination in pharmacies, and parent education sessions.

“It is essential that we continue to develop and foster the relationships and resources that allow GPs, LMCs and primary health organisations to work together to improve the vaccination rate of pregnant mothers,” the researchers write.

“Adoption of the integrated healthcare approach, as found in Taupo/Turangi, could help improve the vaccination rate of all pregnant mothers in New Zealand.”

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