Embedding the delivery of antenatal vaccination within routine antenatal care: a key opportunity to improve uptake

ABSTRACT

Improving the uptake of vaccination in pregnancy has been highlighted as a priority by the World Health Organisation, yet establishing the optimal location for delivery of the antenatal vaccination program remains a topic of debate internationally. In many countries, antenatal vaccines are usually delivered within Primary Care (under the lead of general practitioners [GPs] or family physicians), yet this often presents a logistic barrier to accessing vaccination, and increasing evidence demonstrates that embedding vaccination within routine antenatal care visits may significantly improve uptake. In this commentary, we discuss recent evidence to support this approach, including anonymous feedback from patients and staff at our own institution, in which a dedicated midwife-led vaccine clinic has recently been set up. Furthermore, we highlight a number of individual and institution-level barriers which would need addressing before this approach can be routinely adopted, and suggest targets for future education and research.

KEYWORDS:

• Maternal vaccination
• Pregnancy
• Midwifery
• midwives
• community midwives
• primary care
• secondary care
• antenatal care
• General practice
• family physicians

Acknowledgments

The authors would also like to thank all the pregnant women and health-care staff who took part in the Southampton vaccination clinic questionnaire study.

Author Contributions

C Wilcox drafted the manuscript, and the other authors critically revised the manuscript. All authors approved the final version of the manuscript. With regards to the Southampton vaccination clinic questionnaire study, all authors contributed to questionnaire design, study delivery, and data collection.

Ethical approval

Ethical approval for the Southampton vaccination clinic questionnaire study was obtained from the East of England-Essex research ethics committee (18/EE/0294).

Disclosure of potential conflicts of interest

CRW and CEJ are investigators for clinical trials done on behalf of their respective institutions, sponsored by various vaccine manufacturers, but receive no personal funding for these activities. RR is a vaccination specialist midwife working at Princess Anne Hospital, Southampton.

Additional information

Funding

No funding was obtained for the writing of this commentary, or the undertaking of the Southampton vaccination clinic questionnaire study.