VIP-IDEAL research study, version 1
Research type
Research Study
Full title
Maternal vaccination uptake in socially and ethnically diverse communities: a qualitative study among pregnant/post-partum women and service providers in London to inform the co-production of future health interventions
IRAS ID
309920
Contact name
Sima Berendes
Contact email
Sponsor organisation
London School of Hygiene and Tropical Medicine
Duration of Study in the UK
0 years, 10 months, 31 days
Research summary
Research Summary:
The proposed research project includes the collection of qualitative data to explore reasons for the low uptake of maternal vaccinations in socially and ethnically diverse communities in London and to inform the co-production of future health interventions, policy and practice.Maternal vaccinations (vaccinations during pregnancy) can protect both mother and baby through the transfer of maternal antibodies. Maternal vaccinations have been recommended in the UK for the prevention of flu (since 2010), whooping cough (since 2012) and Covid-19 (since 2021), and vaccines against further infections are currently tested. Maternal vaccine uptake, however, has consistently been far below national targets and unevenly distributed across ethnic groups and regions, with lowest rates among ethnic minority groups in London.
High-quality studies on interventions to address this problem are lacking. Interventions need to be tailored to people most in need, informed by theory and in-depth knowledge of various factors influencing the low uptake. Studies on these factors are rare, and there are none since Covid-19 vaccines have become available.
We therefore propose to conduct one to three focus group discussions and 20-25 semi-structured interviews (via phone, video-conferencing or in-person) with pregnant/recently pregnant women and 15-20 interviews with healthcare workers and other stakeholders in socially and ethnically diverse Boroughs in South London to:
a) understand the complex interplay between various factors contributing to the low maternal vaccine uptake in deprived and ethnic minority communities
b) foster links with communities and stakeholders and inform the co-design of future interventions, including co-produced digital health interventions if appropriate in this setting
The planned study period is February till Dec 2022 and results will be disseminated to scientific and non-scientific communities. The study is supported and funded by the London School of Hygiene and Tropical Medicine and the Wellcome Trust.
Summary of Results:
The pregnant or recently pregnant women in the study said they took either all, none, or some of the vaccines. The most common vaccine they took was for whooping cough, followed by flu and only few took the Covid-19 vaccine. Some women were unsure if they were offered the vaccines, while a few others forgot them or could not get them. A few were advised against the Covid-19 vaccine by their midwives.Many people in the study, including midwives, said that it was up to the pregnant women to do their ‘own research’ about the vaccines and then decide if they wanted them. But many women felt they did not get enough information from midwives about where and when to get the vaccines and how safe and important they are. So they looked for information elsewhere, including online and on social media with the risk of getting wrong information. This made them more worried about vaccine side effects, especially for Covid-19.
Not just the pregnant women, but also some of the healthcare workers were confused when the government changed its advice in April 2021 and said pregnant women should get the Covid-19 vaccines. Some participants found that healthcare workers themselves did not have enough information about the vaccines and needed more training. Many participants found that we need more research to find out if new vaccines have any long-term effects on pregnant women or their babies. Many healthcare workers said that they did not have enough time to discuss vaccines with pregnant women.
Some also said that the computer systems were not good for reminding people about vaccines and keeping track of who got them or what was discussed. Most pregnant women were told about a pregnancy app, but were not told how to use it and did not know it had information about vaccines. Some pregnant women preferred to have information on paper instead of using apps. Some participants also spoke about language problems.
Overall, many participants talked about how the healthcare was organised and how that affected the decisions pregnant women made about vaccines and how to get them. Some participants also discussed where vaccines should be offered, and a few suggested that more vaccines should be offered in pharmacies. Many participants had ideas on how to make things better, for example, giving pregnant women more personalised information in different languages.
REC name
London - South East Research Ethics Committee
REC reference
22/LO/0025
Date of REC Opinion
21 Feb 2022
REC opinion
Further Information Favourable Opinion