Abstract / Summary
Abstract Background Despite high pertussis vaccination coverage rates in infants, pertussis evolves in high-income countries in epidemic cycles, causing an upsurge in hospitalisations and even mortality, especially in children under six months of age. Pertussis vaccination of pregnant women, the complementary vaccination measure encouraged by the World Health Organization in 2012, has been recommended in France since 2022. This study aims to measure pertussis vaccination uptake among pregnant women in Loire-Atlantique, and to highlight the barriers to and drivers of this strategy. Methods This mixed-methods study included a cross-sectional survey and interviews amongst women having recently given birth in three maternity wards. Vaccination status and sociodemographic data were collected face-to-face and semi-structured interviews were conducted among a sample of women. Descriptive statistics and multivariate analysis of the sociodemographic factors associated with vaccination were performed to analyse quantitative data; thematic analyses were applied to qualitative data. Results A total of 388 participants were included in the study between March and September 2024. Of these, 306 had received a pertussis vaccine during pregnancy, representing an estimated vaccination coverage of 79% (95% confidence interval (CI), 74–83%), while vaccination coverage rates for influenza and for Covid-19 were 37% (145/388) and 16% (61/388), respectively. Multivariate analysis revealed that primiparity, a high level of education, and influenza vaccination were associated with pertussis vaccination (odds ratios (OR), 2.64 [95% CI, 1.47–4.90], 1.82 [95% CI, 1.03–3.23], and 5.64 [95% CI, 2.79–12.6], respectively). The qualitative data suggested that the benefits for themselves and their infants were important factors in the women’s decision to be vaccinated, but emphasised that they needed more information about vaccines in order to make that choice and be confident about their decision. Conclusion Two years after the national vaccination recommendation, the pertussis vaccination uptake rate among pregnant women in Loire-Atlantique is high. The favourable factors and barriers identified offer avenues for improving vaccination coverage among pregnant women, particularly those identified as more hesitant, and for facilitating dialogue with healthcare professionals involved in antenatal care. Clinical trial number Not applicable