|dc.description.abstract||BACKGROUND: New Zealand (NZ) experienced a major epidemic of pertussis (whooping cough) from September 2011 to January 2014. With numbers of pertussis notifications reported totalling 5793 in 2012, compared with 1392 notifications in 2011; infants less than one year of age represented 7% of cases reported in 2012. The Canterbury region had high numbers of notifications reported therefore, the Canterbury District Health Board (CDHB) were first to fund the pertussis-containing (tetanus, diphtheria, and acellular pertussis (Tdap)) vaccine for pregnant women 30-36 weeks’ gestation and two weeks postpartum living in the CDHB area; after considering international and national recommendations. The research study’s main focus was to explore the factors influencing pregnant women relating to their decisions about having the pertussis-containing vaccine.
AIM: This involves two separate research projects: Study One’s primary aim was to explore the factors influencing women’s decisions regarding having the pertussis vaccine during pregnancy. Study Two’s primary aim was to explore whether the acceptance of immunisation during pregnancy is associated with infant immunisation status and timeliness.
METHODS: The thesis comprises two separate studies using quantitative, retrospective, observational cohort research designs; conducted within the CDHB area. Study One explored the influencing factors of women considering Tdap vaccine during pregnancy, and utilised a self-reported survey approach, and data collection with 596 postpartum women occurred from June to October 2013. Study Two investigated whether the acceptance of immunisation during pregnancy will influence infants’ vaccination status and timeliness at six weeks, three months, and five months of age with 363 infants of women who had received the Tdap vaccine in pregnancy. Study Two collected retrospective data retrieved from NZ National Immunisation Register (NIR).
RESULTS: The findings indicate the main influencing factors of women who accepted the Tdap vaccine during pregnancy were: the desire to protect their baby, the recommendation from a health professional, the threat of pertussis in the community, and that the vaccine was funded. In contrast, women who did not receive the Tdap vaccine reported the main influencing factors to be; that they did not know the vaccine was available, fear of side effects, and doubt regarding vaccine effectiveness. A health professional’s recommendation was found to be a significant influencing factor, however it would appear that there are a number of health professionals not communicating any or sufficient information to their patients. In fact a proportion provided discouraging information to women which led to them deciding not to get vaccinated. Infants of women who had received Tdap vaccination during pregnancy were more likely to receive their primary immunisation series on-time.
CONCLUSION: No previous NZ study has investigated the factors that influence women’s choice to be immunised during pregnancy. A clear health professional recommendation for maternal Tdap immunisation was a significant factor influencing pregnant women in making such a choice. Improving the amount of positive messages women receive about Tdap vaccination during pregnancy would most likely improve the uptake of the vaccine and increase protection of infants from pertussis. Receipt of Tdap vaccine during pregnancy appears to have a positive effect for on-time infant immunisations.||