Do intentions lead to action? Results of a longitudinal study assessing determinants of Tdap vaccine uptake during pregnancy in Quebec, Canada
Abstract Background In Canada, vaccination against pertussis (Tdap) during pregnancy has been recommended since 2018, with suboptimal uptake. We aimed to assess the determinants of intention and uptake of Tdap vaccine among pregnant women in Quebec. Methods Participants (< 21 weeks of pregnancy)...
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-022-04809-6 |
| _version_ | 1829111705061294080 |
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| author | Eve Dubé Marie-Eve Trottier Maryline Vivion Manale Ouakki Nicholas Brousseau Maryse Guay Zineb Laghdir Isabelle Boucoiran Bruce Tapiéro Caroline Quach |
| author_facet | Eve Dubé Marie-Eve Trottier Maryline Vivion Manale Ouakki Nicholas Brousseau Maryse Guay Zineb Laghdir Isabelle Boucoiran Bruce Tapiéro Caroline Quach |
| author_sort | Eve Dubé |
| collection | DOAJ |
| description | Abstract Background In Canada, vaccination against pertussis (Tdap) during pregnancy has been recommended since 2018, with suboptimal uptake. We aimed to assess the determinants of intention and uptake of Tdap vaccine among pregnant women in Quebec. Methods Participants (< 21 weeks of pregnancy) were recruited in four Quebec regions. Two online surveys were administered during pregnancy (< 21 weeks and > 35 weeks). One measured vaccination intention and the other assessed the actual decision. Questionnaires were informed by the Theory of Planned Behaviour (TPB). We used logistic multivariate analysis to identify determinants of Tdap vaccination uptake during pregnancy using responses to both questionnaires. Results A total of 741 women answered the first survey and 568 (76.7%), the second survey. In the first survey most participants intended to receive the Tdap vaccine during their pregnancy (76.3%) and in the second survey, 82.4% reported having been vaccinated against Tdap during their pregnancy. In multivariate analysis, the main determinants of vaccine uptake were: a recommendation from a healthcare provider (OR = 7.6), vaccine intention (OR = 6.12), social norms (or thinking that most pregnant women will be vaccinated (OR = 3.81), recruitment site (OR = 3.61 for General Family Medicine unit) perceived behavioral control (or low perceived barriers to access vaccination services, (OR = 2.32) and anticipated feeling of guilt if not vaccinated (OR = 2.13). Safety concerns were the main reason for not intending or not receiving the vaccine during pregnancy. Conclusion We observed high vaccine acceptance and uptake of pertussis vaccine in pregnancy. The core components of the TPB (intention, social norms and perceived behavioral control) were all predictors of vaccine uptake, but our multivariate analysis also showed that other determinants were influential: being sufficiently informed about Tdap vaccination, not having vaccine safety concerns, and anticipated regret if unvaccinated. To ensure high vaccine acceptance and uptake in pregnancy, strong recommendations by trusted healthcare providers and ease of access to vaccination services remain instrumental. |
| first_indexed | 2024-12-12T12:25:20Z |
| format | Article |
| id | doaj.art-a2e4ebc980fa4c1983a98360636cda5a |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-12T12:25:20Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-a2e4ebc980fa4c1983a98360636cda5a2022-12-22T00:24:34ZengBMCBMC Pregnancy and Childbirth1471-23932022-06-012211910.1186/s12884-022-04809-6Do intentions lead to action? Results of a longitudinal study assessing determinants of Tdap vaccine uptake during pregnancy in Quebec, CanadaEve Dubé0Marie-Eve Trottier1Maryline Vivion2Manale Ouakki3Nicholas Brousseau4Maryse Guay5Zineb Laghdir6Isabelle Boucoiran7Bruce Tapiéro8Caroline Quach9Direction des risques biologiques et de la santé au travail, Institut national de la santé publique du QuébecDirection des risques biologiques et de la santé au travail, Institut national de la santé publique du QuébecDirection de la valorisation scientifique et qualité, Institut national de la santé publique du QuébecDirection des risques biologiques et de la santé au travail, Institut national de la santé publique du QuébecDirection des risques biologiques et de la santé au travail, Institut national de la santé publique du QuébecDirection des risques biologiques et de la santé au travail, Institut national de la santé publique du QuébecCHU Sainte-Justine Research CenterCHU Sainte-Justine Research CenterInfectious Diseases Division, Department of Pediatrics, CHU Sainte-JustineCHU Sainte-Justine Research CenterAbstract Background In Canada, vaccination against pertussis (Tdap) during pregnancy has been recommended since 2018, with suboptimal uptake. We aimed to assess the determinants of intention and uptake of Tdap vaccine among pregnant women in Quebec. Methods Participants (< 21 weeks of pregnancy) were recruited in four Quebec regions. Two online surveys were administered during pregnancy (< 21 weeks and > 35 weeks). One measured vaccination intention and the other assessed the actual decision. Questionnaires were informed by the Theory of Planned Behaviour (TPB). We used logistic multivariate analysis to identify determinants of Tdap vaccination uptake during pregnancy using responses to both questionnaires. Results A total of 741 women answered the first survey and 568 (76.7%), the second survey. In the first survey most participants intended to receive the Tdap vaccine during their pregnancy (76.3%) and in the second survey, 82.4% reported having been vaccinated against Tdap during their pregnancy. In multivariate analysis, the main determinants of vaccine uptake were: a recommendation from a healthcare provider (OR = 7.6), vaccine intention (OR = 6.12), social norms (or thinking that most pregnant women will be vaccinated (OR = 3.81), recruitment site (OR = 3.61 for General Family Medicine unit) perceived behavioral control (or low perceived barriers to access vaccination services, (OR = 2.32) and anticipated feeling of guilt if not vaccinated (OR = 2.13). Safety concerns were the main reason for not intending or not receiving the vaccine during pregnancy. Conclusion We observed high vaccine acceptance and uptake of pertussis vaccine in pregnancy. The core components of the TPB (intention, social norms and perceived behavioral control) were all predictors of vaccine uptake, but our multivariate analysis also showed that other determinants were influential: being sufficiently informed about Tdap vaccination, not having vaccine safety concerns, and anticipated regret if unvaccinated. To ensure high vaccine acceptance and uptake in pregnancy, strong recommendations by trusted healthcare providers and ease of access to vaccination services remain instrumental.https://doi.org/10.1186/s12884-022-04809-6ImmunizationPertussisPregnancyPublic healthKnowledge, attitudes |
| spellingShingle | Eve Dubé Marie-Eve Trottier Maryline Vivion Manale Ouakki Nicholas Brousseau Maryse Guay Zineb Laghdir Isabelle Boucoiran Bruce Tapiéro Caroline Quach Do intentions lead to action? Results of a longitudinal study assessing determinants of Tdap vaccine uptake during pregnancy in Quebec, Canada BMC Pregnancy and Childbirth Immunization Pertussis Pregnancy Public health Knowledge, attitudes |
| title | Do intentions lead to action? Results of a longitudinal study assessing determinants of Tdap vaccine uptake during pregnancy in Quebec, Canada |
| title_full | Do intentions lead to action? Results of a longitudinal study assessing determinants of Tdap vaccine uptake during pregnancy in Quebec, Canada |
| title_fullStr | Do intentions lead to action? Results of a longitudinal study assessing determinants of Tdap vaccine uptake during pregnancy in Quebec, Canada |
| title_full_unstemmed | Do intentions lead to action? Results of a longitudinal study assessing determinants of Tdap vaccine uptake during pregnancy in Quebec, Canada |
| title_short | Do intentions lead to action? Results of a longitudinal study assessing determinants of Tdap vaccine uptake during pregnancy in Quebec, Canada |
| title_sort | do intentions lead to action results of a longitudinal study assessing determinants of tdap vaccine uptake during pregnancy in quebec canada |
| topic | Immunization Pertussis Pregnancy Public health Knowledge, attitudes |
| url | https://doi.org/10.1186/s12884-022-04809-6 |
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