Are Pregnant Women Receiving the Influenza and Pertussis Vaccines? A Retrospective Cohort Study Looking at the Uptake in a GP Practice in South West London

Problem

I have an interest in paediatrics and women's health, particularly during pregnancy due to this being such a unique period of time. The vaccination programme for pregnant woman is a simple and effective way to improve women's health and to reduce the risk of serious complications, including death, in new born babies. However, not all women agree to having these vaccines which could result in adverse outcomes. The aims of this study were to look at how effective these programmes are by assessing the uptake of both vaccines, investigating if the pertussis vaccine is given within the recommended time period and identifying factors that may affect uptake.

Approach

A retrospective cohort study was conducted at one GP practice in South West London. The cohort included 117 women, all of whom were currently pregnant or had been in the last 42 weeks. The data was then analysed to assess vaccine uptake, when the vaccines were given and to try to identify any factors resulting in reduced uptake.

Findings

The results showed that 63.25% of women received the influenza vaccine and 68.38% received the pertussis vaccine. 10.26% of women were not yet eligble for the vaccine based on the number of weeks gestation they were. The uptake of both vaccines at this GP practice was higher than the reported national average but still below the WHO recommended guidance suggesting work still needs to be done to reach these targets. All women who had the pertussis vaccine received it within the acceptable time frame but 6.25% were given it before 28 weeks gestation which is before the optimum time for antibody transfer. “Other White European” had the lowest uptake of the influenza vaccine compared to other ethnicities at 30.77%. Uptake of influenza was higher in women who were pregnant with their first child at 73.68% compared to 53.19% in those who had at least one other child. Interestingly, the uptake of pertussis was lower in women who were pregnant with their first child compared to those who weren't at 87.50% and 96.77% respectively.

Consequences

The results suggest that more work is needed in order to try and encourage all women to receive these vaccines. It is difficult to identify factors that significantly affect vaccination uptake and therefore it is important to try and encourage all women to receive the vaccines. One group to potentially focus on are “other white European” women particularly for the influenza vaccination. To ensure optimum transfer of antibodies from mother to baby to provide maximum passive immunity it should be encouraged to receive the pertussis vaccination between 28 to 32 weeks.