"Maternal Vaccination Greatly Depends on Your Trust in the Healthcare System": A Qualitative Study on the Acceptability of Maternal Vaccines among Pregnant Women and Healthcare Workers in Barcelona, Spain
Por:
Marín-Cos A, Marbán-Castro E, Nedic I, Ferrari M, Crespo-Mirasol E, Ventura LF, Zamora BN, Fumadó V, Menéndez C, Martínez Bueno C, Llupià A, López M, Goncé A and Bardají A
Publicada:
1 dic 2022
Ahead of Print:
25 nov 2022
Resumen:
The World Health Organization (WHO) identified vaccine hesitancy as one of the top 10 threats to global health in 2019. Health promotion and education have been seen to improve knowledge and uptake of vaccinations in pregnancy. This qualitative study was conducted based on phenomenology, a methodological approach to understand first-hand experiences, and grounded theory, an inductive approach to analyse data, where theoretical generalisations emerge. Data were collected through semi-structured interviews with pregnant women attending antenatal care services and healthcare workers (HCWs) in Barcelona, Spain. Interviews were audio-recorded, transcribed, and coded, and notes were taken. Inductive thematic analysis was performed, and data were manually coded. Pertussis was reported as the most trusted vaccine among pregnant women due to its long-standing background as a recommended vaccine in pregnancy. The influenza vaccine was regarded as less important since it was perceived to cause mild disease. The COVID-19 vaccine was the least trustworthy for pregnant women due to uncertainties about effectiveness, health effects in the mid- and long-term, the fast development of the vaccine mRNA technology, and the perceptions of limited data on vaccine safety. However, the necessity to be vaccinated was justified by pregnant women due to the exceptional circumstances of the COVID-19 pandemic. The recommendations provided by HCW and the established relationship between the HCW, particularly midwives, and pregnant women were the main factors affecting decision-making. The role of mass media was perceived as key to helping provide reliable messages about the need for vaccines during pregnancy. Overall, vaccines administered during pregnancy were perceived as great tools associated with better health and improved quality of life. Pregnancy was envisioned as a vulnerable period in women's lives that required risk-benefits assessments for decision-making about maternal vaccinations. A holistic approach involving the community and society was considered crucial for health education regarding maternal vaccines in support of the work conducted by HCWs.
Filiaciones:
Marín-Cos A:
ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
Marbán-Castro E:
ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
Nedic I:
ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
Ferrari M:
ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
Crespo-Mirasol E:
BCNatal-Barcelona Center of Maternal-Fetal and Neonatal Medicine, Department of Maternal-Fetal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, 08007 Barcelona, Spain
Ventura LF:
ASSIR Esquerra, Gerència Territorial de Barcelona, Institut Català de la Salut, 08015 Barcelona, Spain
Zamora BN:
ASSIR Esquerra, Gerència Territorial de Barcelona, Institut Català de la Salut, 08015 Barcelona, Spain
Fumadó V:
ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
Menéndez C:
ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique
Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Barcelona, Spain
Martínez Bueno C:
ASSIR Barcelona Ciutat, Gerència Territorial de Barcelona, Institut Català de la Salut i Universitat de Barcelona, 08007 Barcelona, Spain
Llupià A:
ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
Department of Preventive Medicine and Epidemiology, Hospital Clinic, Universitat de Barcelona, 08036 Barcelona, Spain
López M:
BCNatal-Barcelona Center of Maternal-Fetal and Neonatal Medicine, Department of Maternal-Fetal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, 08007 Barcelona, Spain
Goncé A:
BCNatal-Barcelona Center of Maternal-Fetal and Neonatal Medicine, Department of Maternal-Fetal Medicine, Hospital Clínic and Hospital Sant Joan de Déu, Universitat de Barcelona, 08007 Barcelona, Spain
Bardají A:
ISGlobal, Hospital Clínic-Universitat de Barcelona, 08036 Barcelona, Spain
Centro de Investigação em Saúde de Manhiça (CISM), Maputo 1929, Mozambique
Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Barcelona, Spain
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