Flu vaccination during pregnancy

Role: primary supervisor of work undertaken in fulfillment of PhD by Dr Jo Parsons

Funder: Coventry University PhD studentship and Warwickshire County Council

Dates: September 2015 to September 2018

Background

The World Health Organisation identifies pregnant women as the highest priority group for flu vaccination. Uptake amongst pregnant women in England is poor; in 2020/21 only 44% received the vaccination. Each year in the UK there are over 2 million maternities. It has been estimated that one in 11 maternal deaths can be attributed to flu.

What did we do?

Using Intervention Mapping, and working with pregnant women and other key stakeholders, we co-designed an intervention to increase flu vaccination amongst pregnant women. Development included an evidence review, interviews with 24 pregnant women, and expert consultation. The intervention was evaluated using a pre-post design.

What did we develop?

Pregnant women were found to hold a range of unhelpful/inaccurate beliefs that may be leading them to underestimate their risk from flu including: that they were at no greater risk of flu due to pregnancy, that flu was no more serious during pregnancy than it would otherwise be, that flu could be prevented through ‘good hygiene’ and staying ‘fit and healthy’, and also that flu could be cured. Furthermore, there were concerns about the safety of the vaccine, particularly to the developing baby. The intervention developed was an animation addressing these beliefs ('Protection from flu, for baby and you').

What did we find?

Preliminary testing using qualitative methodology indicated that the information provided within the animation was appropriate, and that it was acceptable to pregnant women. Subsequent quantitative testing involving 411 unvaccinated pregnant women found that watching the animation led to increased appraisals of likelihood of getting flu while pregnant and severity of flu during pregnancy, and increased intentions to accept flu vaccination during pregnancy. Of the 67 respondents who completed follow-up survey two, 38 (56.7%) reported having the vaccination while pregnant.

Impact

The animation was launched by Warwickshire County Council in October 2018 who embedded it on their local government website (amongst other flu resources) and distributed via social media. It was shown to community midwives working within Coventry and Warwickshire at their team meetings with the request made to signpost their patients to this. Small keyring cards to attach to their lanyards with the URL and QR code for the animation on them were distributed to the midwives to support them in doing this.

Publications

Parsons, J.E., Newby, K.V., French, D.P., Bailey, E., & Inglis, N. (2021). The development of a digital intervention to increase influenza vaccination amongst pregnant women. Digital Health, doi: 10.1177/20552076211012128.

Parsons, J.E., Newby, K.V., & Grimley, C. (2022). Effectiveness of a Digital Intervention in Increasing Flu Vaccination Related Risk Appraisal, Intention to Vaccinate and Vaccination Behaviour Amongst Pregnant Women. Health Education and Behaviour, doi:10.1177/10901981221077935.

Click on image below to watch the video