Peer-reviewed article
Maternal Vaccination as an Integral Part of Life-Course Immunization: A Scoping Review of Uptake, Barriers, Facilitators, and Vaccine Hesitancy for Antenatal Vaccination in Ireland.
Sanni A, Ibrahim N, Tilley D, Bontha S, McMorrow A et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This scoping review examined maternal vaccination uptake, barriers, and vaccine hesitancy in Ireland, focusing on antenatal vaccines including Tdap, influenza, and COVID-19. The review of 12 studies found that vaccination rates remain suboptimal despite clear guidelines. Key barriers included insufficient knowledge among pregnant women and healthcare providers about vaccine safety in pregnancy, while maternal motivation to protect infants and healthcare provider recommendations were important facilitators. Improved provider training, public awareness campaigns, and clearer communication about vaccine safety during pregnancy are needed to increase uptake.
Key points
- Maternal vaccination uptake in Ireland remains suboptimal despite WHO recommendations and national guidelines for antenatal Tdap, influenza, and COVID-19 vaccines
- Healthcare provider recommendation and knowledge of vaccine safety were the strongest positive factors influencing vaccination uptake
- Major barriers included maternal lack of knowledge about vaccine-preventable illness severity and vaccine safety in pregnancy, and reluctance of some healthcare providers to prescribe all recommended antenatal vaccines
- Protection of the infant was the primary motivation for pregnant women to accept antenatal vaccination
- Coordinated approaches addressing healthcare provider knowledge, maternal awareness through public campaigns, and clear safety information in pregnancy are needed to meet WHO life-course immunization goals
Limitations
This scoping review synthesises existing research in Ireland but does not provide new primary data on current vaccination rates or specific prevalence of hesitancy. The findings may not represent all pregnant women's experiences or perspectives not captured in the included studies.
Abstract
Background: Maternal vaccination is a critical primary preventive approach and an integral part of life-course immunization strategy, influencing the infection-associated morbidity and mortality in pregnant women, foetuses, and young infants. Despite clear guidelines for the administration of vaccines against tetanus, diphtheria, pertussis (Tdap), influenza, and COVID-19 during pregnancy, maternal vaccination rates remain suboptimal in Ireland as per the National Immunisation Office of the Health Service Executive (HSE). Aim: This review explores the prevailing status, uptake factors, and maternal immunization-specific vaccine hesitancy in Ireland. Method: A scoping review was conducted, searching nine electronic databases, including the Irish health research repository Lenus. The search strategy utilised a Population-Concept-Context framework (pregnant women-vaccine uptake/hesitancy-Ireland). Key factors identified and categorised according to the 5A framework: access, affordability, awareness, acceptance, and activation. Results: Searches yielded 2457 articles, and 12 eligible studies were included for review. Influencing factors were identified in each of the 5A dimensions, with the majority relating to acceptance and awareness. Positively associated factors included healthcare provider (HCP) recommendation and knowledge of vaccine safety. Potential antenatal barriers were maternal lack of knowledge of vaccine-preventable illness severity, infection risks, and vaccine safety concerns. A pregnant woman's primary motivation for antenatal immunization was protection of her infant; however, the reluctance of HCPs to prescribe all recommended antenatal vaccines, inadequate immunization-specific discussion during antenatal consultations, and suboptimal knowledge of pregnancy-specific vaccine safety hampered potential positive influences. The Irish national immunization policy was a facilitator of affordability. Activation can be achieved through public health awareness campaigns and interdisciplinary promotion of maternal vaccination uptake. Conclusions: Maternal vaccination uptake in Ireland remains suboptimal, and a coordinated, targeted approach updating HCP recommendations, enhancing maternal awareness, and highlighting vaccine safety in pregnancy would be required to meet the life-course immunization goals recommended by WHO. By adopting a life-course immunization approach for healthy living, with maternal vaccination as the pivotal central point, vaccination programmes could close immunity gaps at various life stages.