Messages about safety and how vaccines protect infants motivate pregnant women to get immunized, especially when they are delivered by trusted health care workers, according to a survey published in Women’s Health Issues.
“The study was prompted by a desire to improve low rates of maternal vaccinations, which leave moms and babies at risk for preventable diseases,” author Rebecca Perkins, MD, associate professor of obstetrics and gynecology at the Boston University School of Medicine, told Healio.
The researchers interviewed 28 pregnant women aged 18 to 40 years, with an average age of 25.3 years, who received prenatal care at a safety net hospital between Dec. 1, 2019, and June 25, 2020. Almost 60% identified as non-Hispanic Black or African American, 35% as Hispanic or Latino and 4% as Asian.
Participants were interviewed about their attitudes toward vaccinations in general and vaccinations for influenza and Tdap in particular during pregnancy. The participants also provided feedback about specific messages regarding maternal vaccination.
Nineteen of the participants said that routine childhood vaccinations were very important, seven said they were important and one said they were safe. Also, 11 said that their children had received their routine vaccines on schedule.
When asked about routine vaccinations for adults, 58% said they were very important and 35% said they were important. Participants raised concerns about influenza vaccines, though, and three said they did not see any value in vaccinating adults.
Also, most of the participants had heard about vaccines from multiple sources, but all of them said they trusted their health care providers most as a source of vaccine information.
Most participants felt motivated to get vaccinated when scientific explanations were provided, especially when it was explained to them how antibodies created by the mother crossed the placenta to give the baby short-term immunity after birth that lasts until the baby is old enough to get vaccinated on their own.
The researchers said vaccine safety concerns were the most important barrier to vaccination that the participants articulated. According to 17 of the participants, the most important message in these communications was protection for the mother and the baby.
In fact, the researchers said, the participants expressed more motivation to vaccinate for their babies than for themselves. None of the participants expressed any concerns or had negative reactions to statements about vaccine safety.
The negative consequences of diseases for pregnant women generally did not motivate the participants to get vaccinated, however. The researchers said this finding was important because patient-oriented literature about maternal influenza vaccination often emphasizes the potential complications of infection.
“The most important finding was that fear-based messaging was not effective. It is tempting to try to persuade people to vaccinate by detailing the terrible outcomes of severe vaccine-preventable diseases, but our research and others indicates that this is not the most effective approach,” said Perkins.
The researchers currently have a similar ongoing study about attitudes among English-speaking and Spanish-speaking individuals toward the COVID-19 vaccines and plan to report their findings once the study is complete.
Meanwhile, doctors can improve their own communication with patients about vaccines, and it begins by establishing relationships.
“Both patients and health care providers consistently indicate that communication is better when they have known each other for a long time and feel comfortable discussing health topics and working together,” said Perkins.
When providers discuss vaccines, Perkins said, the first step is to clearly explain that the vaccine is due at this time, why it is important, how it will help protect the mother and baby and that it has a track record of safety during pregnancy.
Perkins suggested a script that doctors could use in these discussions.
“Now that you are in the third trimester of pregnancy, it is time for the Tdap vaccine, which protects against tetanus, diphtheria and whooping cough. We have been giving this vaccine to pregnant women for many years, and it is safe for you and your baby,” she suggested.
“The vaccine will protect you and your baby against whooping cough. Whooping cough can be very dangerous for small babies whose lungs are not well developed. Giving you the vaccine now will protect your baby until she is old enough to get her own vaccines,” she added.
After that initial discussion, Perkins said, patients should ask any remaining questions and have their concerns addressed with open dialogue.
