Maternal vaccination provision in NHS maternity trusts across England.
Emma C Anderson, Peter S Blair, Adam Finn, Jenny Ingram, Gayatri Amirthalingam, Christie Cabral
Author Information
Emma C Anderson: Centre for Academic Child Health, Bristol Medical School: Population Sciences, University of Bristol, Canynge Hall, Third Floor, 39 Whatley Road, Bristol BS8 2PS, United Kingdom; NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom. Electronic address: emma.anderson@bristol.ac.uk.
Peter S Blair: Centre for Academic Child Health, Bristol Medical School: Population Sciences, University of Bristol, Canynge Hall, Third Floor, 39 Whatley Road, Bristol BS8 2PS, United Kingdom. Electronic address: p.s.blair@bristol.ac.uk.
Adam Finn: Centre for Academic Child Health, Bristol Medical School: Population Sciences, University of Bristol, Canynge Hall, Third Floor, 39 Whatley Road, Bristol BS8 2PS, United Kingdom. Electronic address: adam.finn@bristol.ac.uk.
Jenny Ingram: Centre for Academic Child Health, Bristol Medical School: Population Sciences, University of Bristol, Canynge Hall, Third Floor, 39 Whatley Road, Bristol BS8 2PS, United Kingdom. Electronic address: jenny.ingram@bristol.ac.uk.
Gayatri Amirthalingam: UK Health Security Agency, Nobel House, 17 Smith Square, London SW1P 3JR, United Kingdom. Electronic address: gayatri.amirthalingam@ukhsa.gov.uk.
Christie Cabral: NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, United Kingdom. Electronic address: christie.cabral@bristol.ac.uk.
BACKGROUND: Vaccinations for seasonal influenza and pertussis have been recommended for pregnant women in England since 2010 and 2012, respectively. Uptake rates are suboptimal with large regional variations. To improve uptake, from 2016 onwards maternity trusts were commissioned to offer pertussis (and other) vaccinations in addition to these being available in primary care. Since 2021, Covid-19 vaccination has also been recommended for pregnant women. Overall maternal vaccination rates are routinely available, but not the relative provision by maternity trusts. We aimed to describe the national picture of maternity trust provision of maternal vaccinations, including how the maternity trust vaccination programme has progressed. METHODS: Cross-sectional survey plus comparisons with 2017-18 figures for maternity trust provision of pertussis vaccination, and with UKHSA data for total pertussis vaccination. RESULTS: Twelve NHS commissioners participated (from 13/06/22 to 31/03/23) providing data for 120 (of a total 124) maternity trusts across England. All 120 (100%) trusts were commissioned to deliver influenza, and 107 (89%) to deliver pertussis vaccinations, though not all actually administered the vaccines; 29% offered Covid-19 vaccinations. For 2021-22 we found a mean of 25% (range 0-81.3%) women were vaccinated for pertussis (a large increase compared with previous estimates for 2017-18); and 11% (range 0-74.2%) for influenza, via their maternity trust. Commissioners reported a negative impact of the pandemic on routine vaccination provision. There was indication of efficiency by vaccinating women attending for other appointments. There are diverse mechanisms for reporting pertussis and influenza vaccinations administered at maternity trusts back to primary care, which may be inefficient for maternity staff workload and accuracy of data transfer (especially for pertussis). CONCLUSION: A high proportion of maternity trusts provide both pertussis and influenza vaccinations, despite a negative impact of the pandemic. Reasons for large between-trust variation in vaccination rates should be explored to improve uptake and equity.
