Pertussis vaccination uptake in pregnancy: lessons to be learned from an integrated healthcare approach

Authors: Emma J Deverall, Benjamin Gilmore, Sam Illing, Roshini Peiris-John

Reference: NZMA; Vol 131, no 1473

Summarised on: 4 July 2018

This paper reviews the results of an audit to determine the proportion of pregnant women vaccinated with the pertussis booster in the third trimester of their pregnancy, and explores factors influencing coverage.

An audit was conducted of all women who birthed in Rotorua hospital from 25 March 2017 to 25 April 2017. Information relating to whether the patient had received pertussis vaccination in this pregnancy, age, ethnicity, parity, GP and LMC was extracted from the electronic health system.

A total of 111 women were included in the audit review. Only 44% (n=49) were vaccinated. Women aged under 25, and women from Rotorua were less likely to be vaccinated. A woman not being recalled to the GP for vaccination was the biggest reason for not being vaccinated (n=27). Every woman in Taupo/Turangi was recalled in pregnancy, leading to greater vaccine uptake compared to women in Rotorua (76% vs 45%).

It was noted that women in Taupo and Turangi have access to a greater number of interventions within an integrated healthcare approach. Unlike in Rotorua, the Taupo maternity unit takes responsibility for notifying GPs of their patient’s pregnancy. GPs are then able to recall patients to discuss vaccination, and a nurse attends antenatal classes for opportunistic immunisation.

In Turangi a community child health nurse vaccinates women at a monthly clinic.

 The authors conclude that vaccination rates within Rotorua DHB remain low, and that there needs to be more focus on improving delivery of vaccines to young pregnant women. They conclude that adoption of the integrated healthcare approach, as found in Taupo/Turangi, could help improve the vaccination rate of all pregnant mothers in New Zealand.


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