Improving Influenza Vaccine Uptake During Pregnancy Through Vaccination at Point of Care: A Before-and-After Study.

OBJECTIVES: Vaccine administration where pregnant individuals receive prenatal care may increase vaccine coverage. Availability of influenza vaccine at prenatal care visits is not standard in Canada. Since the 2016-2017 influenza season, pregnant individuals can receive the influenza vaccine at the point of care (POC) in an urban clinic in Calgary, Alberta. The objective of this study was to descriptively examine vaccination rates across multiple influenza seasons for a POC vaccination in pregnancy (VIP) intervention and describe associations between influenza vaccine coverage and comorbidities and area-level socioeconomic status. METHODS: A before-and-after study design was used to examine vaccine coverage across 6 consecutive influenza seasons: 2 before (2014-2015 and 2015-2016) and 4 after POC-VIP implementation (2016-2017 to 2019-2020). We identified the birth cohort and measured influenza vaccine uptake using clinical and administrative databases. Influenza vaccination rates were computed and compared using the Fisher exact test with statistical significance at a P value of 0.05. RESULTS: A total of 4443 pregnancies were identified during the study period. The influenza vaccination rate increased in the intervention years at 40.1 per 1000 patient-weeks (P < 0.001), compared to the pre-intervention influenza seasons at 11.7 per 1000 patient-weeks. Vaccine coverage did not statistically differ between pregnancies with or without comorbidities across most seasons. Vaccine coverage decreased as material deprivation increased in pre-intervention years. CONCLUSIONS: The vaccination rate was higher in the intervention years compared to the pre-intervention period. In this study, we applied a systematic methodology to examine vaccine coverage in pregnancy and presented a descriptive examination of a POC-VIP intervention.

Resources available for parent-provider vaccine communication in pregnancy in Canada: a scoping review.

OBJECTIVE: Vaccination in pregnancy (VIP) is a protective measure for pregnant individuals and their babies. Healthcare provider's (HCP) recommendations are important in promoting VIP. However, a lack of strong recommendations and accessible resources to facilitate communication impact uptake. This study sought to determine the extent of and characterise the resources available for parent-provider vaccine communication in pregnancy in Canada using a behavioural theory-informed approach. DESIGN: Scoping review. METHODS: In accordance with the JBI methodology, nine disciplinary and interdisciplinary databases were searched, and a systematic grey literature search was conducted in March and January 2022, respectively. Eligible studies included resources available to HCPs practising in Canada when discussing VIP, and resources tailored to pregnant individuals. Two reviewers piloted a representative sample of published and grey literature using inclusion-exclusion criteria and the Authority, Accuracy, Coverage, Objectivity, Date, Significance guidelines (for grey literature only). Sixty-five published articles and 1079 grey reports were screened for eligibility, of which 19 articles and 166 reports were included, respectively. RESULTS: From the 19 published literature articles and 166 grey literature reports, 95% were driven by the 'Knowledge' domain of the Theoretical Domains Framework, while n=34 (18%) addressed the 'Skills' domain. Other gaps included a lack of VIP-specific tools to address hesitancy and a lack of information on culturally safe counselling practices. CONCLUSION: The study suggests a need for resources in Canada to improve VIP communication skills and improve access to vaccination information for HCPs and pregnant individuals. The absence of such resources may hinder VIP uptake.