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Multi-tiered intervention to increase maternal immunization coverage: A randomized, controlled trial.

Saad B Omer1, Sean T O'Leary2, Robert A Bednarczyk3

  • 1Yale Institute for Global Health, Yale University, New Haven, CT, United States; Department of Health Policy and Management, Yale School of Public Health, Yale University, New Haven, CT, United States; Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, United States; Yale School of Nursing, Yale University, New Haven, CT, United States.

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Summary
This summary is machine-generated.

A multi-component intervention did not significantly increase maternal immunization uptake overall. However, a patient-level intervention improved influenza vaccine uptake in women unsure about receiving it.

Keywords:
InfluenzaMaternal immunizationPertussisQuality improvementVaccine deliveryVaccine uptake

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Area of Science:

  • Public Health
  • Epidemiology
  • Vaccinology

Background:

  • Maternal immunization is crucial for protecting pregnant individuals and infants.
  • Barriers to vaccine uptake in obstetric settings are multifactorial.
  • Targeted interventions are needed to improve vaccine coverage during pregnancy.

Purpose of the Study:

  • To evaluate a multi-component intervention to increase maternal immunization uptake.
  • To assess the impact of practice-, provider-, and patient-level interventions on vaccine uptake.
  • To determine the effectiveness of interventions on influenza and tetanus, diphtheria and acellular pertussis (Tdap) vaccine receipt.

Main Methods:

  • A multi-level, cluster- and individually-randomized controlled trial was conducted.
  • Obstetric practices were randomized to intervention or standard care.
  • Pregnant women were randomized into patient-level intervention and control groups, creating four study arms.

Main Results:

  • No significant overall increase in Tdap or influenza vaccine uptake was observed.
  • A patient-level intervention increased influenza vaccine uptake by 61% in hesitant women.
  • No significant differences in vaccine uptake were found between the four study arms overall.

Conclusions:

  • Targeted interventions are necessary to improve maternal vaccine uptake.
  • Future efforts should focus on clinics with low baseline uptake.
  • Expanding patient-level interventions for women with low vaccine confidence is recommended.