Determinants of policy and uptake of national vaccine programs for pregnant women: results of mixed method study from Spain, Italy, and India

Figures & data

Figure 1. Profile of key respondents interviewed. n = 20 in Spain and India, n = 19 in Italy. Some respondents categorized into multiple job types in Italy

Table 1. Frequently cited drivers of maternal immunization decision-making

India	Italy	Spain
Cost	Newborn protection	Other Country Decisions
Infant mortality rate	Life course vaccination	New adult vaccine calendar implemented 2017/2018
Prime Minister priority	Harmonization of regional vaccine calendars	Shortages in pediatric diphtheria, tetanus, acellular pertussis (DTaP) but not maternal Tdap
Maternal mortality rate	Disease burden	Disease burden
Neonatal disease burden	Mandatory pediatric vaccinations	Safety
		Cocooning
		Cost-effectiveness

Figure 2. Respondent ratings of presence of maternal immunization expertise on NITAGS. 0 = no presence of experts on NITAG/expert working group; 1 = one representative; 2 = 2 representatives; 3 = 3 or more experts on NITAG/expert working group

Figure 3. System-level facilitators and barriers to improving uptake. Key: Inner circle: Factor mentioned by ~100% of respondents, Outer Circle: Other mentioned factors, Size is proportional to frequency that respondents mentioned it as a factor. Advocacy is referring to pediatric and new-born health experts advocating for vaccines to protect baby and mother. Ob-gyn’s seem to not play an influential role in uptake currently in the case study countries