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Perspectives on Maternal Vaccination from Obstetrical Clinicians: A Qualitative Multi-site Study.
Humiston, Sharon G; Szilagyi, Peter G; Bender, Robin G; Breck, Abigail; Albertin, Christina S; Clark, Devin; Rand, Cynthia M.
Afiliación
  • Humiston SG; Department of Pediatrics, Children's Mercy Kansas City, UMKC School of Medicine, 2401 Gillham Road, Kansas City, MO, 64106, USA. sghumiston@cmh.edu.
  • Szilagyi PG; Department of Pediatrics, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, CA, USA.
  • Bender RG; Department of Pediatrics, University of Rochester Medical Center, University of Rochester, Rochester, NY, USA.
  • Breck A; Department of Pediatrics, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, CA, USA.
  • Albertin CS; Department of Pediatrics, UCLA Mattel Children's Hospital, University of California at Los Angeles, Los Angeles, CA, USA.
  • Clark D; Department of Pediatrics, University of Rochester Medical Center, University of Rochester, Rochester, NY, USA.
  • Rand CM; Department of Pediatrics, University of Rochester Medical Center, University of Rochester, Rochester, NY, USA.
Matern Child Health J ; 26(12): 2506-2516, 2022 Dec.
Article en En | MEDLINE | ID: mdl-36315315
OBJECTIVES: Despite the seriousness of influenza and pertussis, availability of safe and effective vaccines against them, and long-standing maternal vaccination recommendations, US maternal influenza and Tdap vaccination rates have been low. To increase vaccination rates in obstetric offices, it is important to understand clinician perspectives and office processes. We conducted in-depth interviews with nurses and providers on these topics. METHODS: Interviewees worked in obstetric offices in one-of-four participating health systems in NY and CA. We audio-recorded and transcribed 20-30-min interviews. We used predetermined categories to code interviews with Dedoose, then iteratively refined codes and identified themes. RESULTS: We conducted 20 interviews between 4/2020 and 9/2020: 13 providers (physician or nurse midwife) (5 NY, 8 CA); 7 office nurses (6 NY, 1 CA). In almost all offices, patient refusal of influenza vaccine was considered the major vaccination barrier; Tdap was often deferred by patients until post-delivery. Nurse-only visits for either vaccine were rare. Vaccination outside the office was uncommon; few offices systematically documented vaccines given elsewhere in a retrievable manner. Participants emphasized patient education as key to prenatal care, but the number of topics left little time for immunizations. Few interviewees could identify an office "immunization champion," knew their office vaccination rates, or had participated in vaccination quality improvement. Several interviewees indicated that they or another provider were good at persuading hesitant patients, but their method had not been shared with other clinicians. CONCLUSIONS FOR PRACTICE: Multiple practical barriers and maternal vaccine hesitancy limit maternal vaccination. Quality improvement strategies are needed.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vacunas contra la Influenza / Tos Ferina / Vacunas contra Difteria, Tétanos y Tos Ferina Acelular / Gripe Humana / Obstetricia Tipo de estudio: Guideline / Qualitative_research Límite: Female / Humans / Pregnancy Idioma: En Revista: Matern Child Health J Asunto de la revista: PERINATOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vacunas contra la Influenza / Tos Ferina / Vacunas contra Difteria, Tétanos y Tos Ferina Acelular / Gripe Humana / Obstetricia Tipo de estudio: Guideline / Qualitative_research Límite: Female / Humans / Pregnancy Idioma: En Revista: Matern Child Health J Asunto de la revista: PERINATOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos