Background
Methods
Aims
Study design and setting
Interview topic guide
Participants and recruitment
Methodology and Analysis
Results
Participant number | Ethnicity | Stage of pregnancy/age of infant | Vaccination status |
---|---|---|---|
1 | Cook Island Māori | Infant is 3 months old | Vaccinated against: - Influenza - Pertussis |
2 | Cook Island Māori | Infant is 6 months old | Not vaccinated |
3 | Samoan | Infant is 11 months old | Vaccinated against: - Influenza - Pertussis |
4 | Samoan | Infant is 2 months old | Vaccinated against: - Influenza |
5 | Māori | 39 weeks pregnant | Vaccinated against: - Influenza |
6 | Samoan | Infant is 6 months old and currently 3 months pregnant | Not vaccinated |
7 | Māori | 8 months pregnant | Vaccinated against: - Pertussis |
8 | Māori | Infant is 9 months old | Vaccinated against: - Influenza |
9 | Māori | 34 weeks pregnant | Not vaccinated |
10 | Māori | Infant is 3 months old | Not vaccinated |
11 | Māori | Infant is 12 months old | Not vaccinated |
12 | New Zealander/ Māori | 8 months pregnant | Not vaccinated |
13 | Māori | 6 months pregnant | Will vaccinate against: - Pertussis |
14 | Māori | 6 months pregnant | Undecided |
15 | Māori | Infant is 3 months old | Vaccinated against: - Pertussis |
Analysis
Node | Themes |
---|---|
Knowledge about vaccination in pregnancy | • Gaps in awareness • Vaccination: Possible protection versus potential harms • Infection: Perceived potential harm and risk of infection |
Influences on decisions | Decided to vaccinate |
• Being well-informed is important • Clear recommendations have impact • Understanding protective benefits | |
Unvaccinated or undecided | |
• Previously held beliefs and practices • Need more effective discussions • Not prioritised |
Gaps in awareness
“I don’t really know a whole lot about the influenza immunisation, it’s kind of just there, it’s always been mentioned but it’s never been, like, talked about.” [P14]
“I think I didn’t know much and I still am not probably fully aware.” [P15].
“Oh, I didn’t have that [the pertussis vaccine]. I didn’t quite have that info, just the flu one.” [P4]
Vaccination: Possible protection versus potential harms
“It improves your health system, and it will also keep baby safe. Like, you know if it’s still in your womb... When they come out, they are still little and if sick you can’t do anything about it until they’re old. So, it’s easy for me to take the vaccination while baby in the womb so it helps keeps them safe as well.” [P4]
“…if I got vaccinated, while pregnant, the baby would have lots of immunity in her own self.” [P15]
“I don’t really know much about them. Just that they protect you from those things, yeah… would just protect you and your baby.” [P11]
“Their baby has ended up in Starship [New Zealand paediatric hospital] or something and they claimed it is from a vaccine… within my circle of friends. Um yeah that scares you a little bit… because it is so personalised.” [P8]
“My cousin, actually, she’s in a wheelchair from being immunised, but that wasn’t while her mum was pregnant. I think it was after. But that whole thing there has put me off altogether. I get my kids done… But not while I am pregnant.” [P9]
“Yes, I did hear information from other women you know they tell me “Don’t take it because if you take it you’re gonna get sick… side effects, this is what is going to happen to you”.” [P2]
Infection: Perceived potential harm and risk of infection
“I just know that if babies do get it [pertussis], it can be really bad… for baby it would be awful… but just from what I looked up I just know that it can be really, I don’t know if it can be fatal or not.” [P15]
“I don’t know [how serious is it] because I haven’t, I don’t know anything about it.” [P10].
“…it’s another sickness that, you know, they’ve got to go through.” [P5].
“Really serious, like really bad. It [influenza] would be a concern for me and especially baby.” [P4]
“I didn’t actually think it would be that bad to be quite honest.” [P8]
“I’ve always just been told it can’t harm the baby.” [P7]
“I think it [influenza] would be serious, not only for me but also for my baby, yeah... yeah could definitely be concerned about it, it could come to the worst of it as well.” [P2]
“[Pertussis infection would be] serious for the baby I think, yeah… what I’ve seen, like, on social media that babies have less of a chance of surviving.” [P11]
“Quite [likely to get influenza], I get quite sick quite easily.” [P5].
“You know with, like, COVID and everything now, everyone’s a lot more, you know, signs their name, washes their hands, sanitises, some people even wear masks and things like that.” [P12]
“Not very likely [to catch influenza]… just because its coming to the end of winter.” [P13].
“I guess I thought it [pertussis infection] was not very likely.” [P8]
“While growing up it was not common where I come from. Whooping cough, I never heard of it. I’ve never have heard of any case, growing up in the Cook Islands, that any babies passed away from that kind of thing.” [P2]
“I think I need to be careful and make myself comfortable and also dress up warm… yeah I think that’s enough.” [P6]
“I feel your body can help itself if it needs to.” [P13].
Influences on decisions
Theme (n) | Comment and example quotes |
---|---|
Being well-informed is important (n = 6) | For some participants, being adequately informed about vaccinations was enough to decide to be vaccinated. “…I read all the information, also my doctor explain[ed] to me what this means. And I’m OK. I’m ok to do it.” [P3] “I wasn’t going to, but when I got more information on it [from the midwife], I decided it would be better for my baby… I actually wasn’t going to get it and then I decided that I should.” [P7] |
Clear recommendations have impact (n = 8) | A third of participants decided to get vaccinated because it was recommended by their GP or midwife. Three participants were positively influenced by their family or friends. A couple of the participants were recommended and offered influenza vaccination through their place of work. “Midwife they tell me to do that thing [get vaccinated].” [P3] “It was my partner’s aunty actually [that told her about vaccination]. So, I just booked an appointment with the doctor.” [P5] “I did have the flu vaccine though. That’s only because we are offered it through work. But otherwise out of work, I don’t know.” [P8] |
Understanding protective benefits (n = 11) | Seven participants decided to vaccinate to ensure their baby was healthy. Four participants wanted to get vaccinated for their own health and safety. “I decided it would be better for my baby… the health of my baby.” [P7] “For baby, and also for the mum as well.” [P3] |
Theme | Comment and example quotes |
---|---|
Previously held beliefs and practices (n = 9) | Some did not get vaccinated because of concerns around the safety of the vaccine for them or their unborn baby. “I don’t want to get anything while I am pregnant. Anything at all, because it may have effects. That’s what I am scared of.” [P9] “I’m sure that there’s a lot of, it’s just a worry that if I do take this like what could potentially go wrong with it.” [P14] |
Some did not trust the advice on vaccination from their healthcare provider. “I’d trust what they’re saying, but I still like to go and do some research because I’m not interested in vaccinating… we could all just go ‘oh yes’ and you know do everything like a robot sort of thing but then there’s also choices… Health professionals are just doing what the government says and how the Ministry of Health are doing things whereas, like, if you wanted to find alternatives and other things like that, you’d have to go and find it yourself.” [P12] “Not really [trust healthcare provider advice about vaccination]… just my beliefs… women have die[d] following vaccination.” [P6] | |
Some decided to not vaccinate because of perceived low likelihood of catching the disease. “It wasn’t [a consideration] at the time, just because I don’t normally get the flu.” [P15] “Not concerned because none of my kids have ever had it.” [P10] | |
Some did not think vaccination was necessary because they do not usually get vaccinated or had not been vaccinated for previous pregnancies “I chose not to get the flu vaccine while I was pregnant and that was just because I’ve never gotten the flu vaccine before so I kind of just figured, just to keep going as normal.” [P15] “I didn’t have it with my first one, so I don’t know why I had to have it with my second one.” [P8] | |
Need more effective discussions (n = 11) | Many participants felt they were not given enough information to decide to vaccinate. Some were not offered the vaccine, and some were unaware of vaccine recommendations. “Just that lack of understanding, what actually is that… It’s just that lack of [information], because all that you are given is that brochure, yes, I’ll read it but I’m the type that would like to know more… It’s not just what’s on the brochure, I need to know more.” [P2] “I didn’t have the whooping cough [vaccine]. That’s because it wasn’t offered to me.” [P8] |
Some described having doubts after discussing vaccination with family and friends. “I didn’t want to get it because I have heard that if you get it, it actually brings it [influenza] on.” [P9] “Other people have their doubts and then they start putting stuff in your head and you’re like, “should I trust this?”.” [P11] | |
Not prioritised (n = 3) | Some were aware of recommendations, but vaccination was not a priority during their pregnancy. “I just made excuses because I forgot or didn’t just have time. But it was never a priority for me to make that decision.” [P2] “I just haven’t got round to it, because I only just finished work two weeks ago.” [P5] |