Factors that influence the uptake of pertussis vaccine in pregnant women in Uruguay

Abstract

Background: Since 2015, pertussis vaccine has been offered universally and free of charge to pregnant women in Uruguay. Although it is mandatory, vaccination coverage is not yet complete. Aim: To study the pertussis vaccination coverage in 2017 in pregnant women in two state hospitals and to search for barriers for uptaking the vaccine. Methods: We conducted an observational, descriptive and transversal study, using a survey in patients undergoing immediate postpartum period. Results: 884 surveys were analyzed (mean age 25.2 years; 16% teenagers, most of them in a relationship and incomplete high school). 317 women (36%) were vaccinated. Main barriers for uptaking Tdap vaccine were: teenage and being single were associated with a greater risk for the uptake. Not being aware of the vaccine mandatoriness and not being informed about its benefits were associated with 9.44 and 4 higher risks for not uptaking the vaccine (IC 95% 6.63-13.45 and IC 95% 2.43-6.41, respectively). Not believing in the benefits of pertussis vaccine during pregnancy was associated with 6.37 higher risk (OR 6.37; IC 95% 4.61-8.78). Discussion: Most pregnant women in this study during 2017 did not uptake pertussis vaccine and did not have medical indication for it. The lack of information about the obligation and benefits, and also patients´ beliefs about the vaccination were identified as barriers. Health professionals who treat pregnant women should recommend and inform about the benefits of pertussis vaccine for women and the infant, and create the necessary perception of risk, in order to improve the vaccination coverage.