Tackling vaccine hesitancy among pregnant women

Nurses and other healthcare professionals across general practice and maternity services must ensure they ‘feel confident’ in having discussions with pregnant women around vaccinations, a webinar focused on tackling vaccine hesitancy has heard.

Speakers at a joint webinar held by the UK Health Security Agency (UKHSA) and NHS England (NHSE) this week highlighted that where a GP practice is aware a patient is pregnant, it is best practice to check her vaccination status and, where appropriate, offer recommended vaccines directly or ensure timely referral to a service that can provide them.

Confidence and empathy in conversations

Dr Helen Campbell, lead scientist in the immunisation division at UKHSA, said healthcare professionals’ confidence plays a key role in vaccine uptake.

She said: ‘One of the key things is to ensure that you feel confident in having that discussion, and that you are well informed about the vaccines and the vaccine programmes offered in pregnancy and the rationale behind them.’

Dr Campbell emphasised the importance of informed and empathetic discussions.

She explained: ‘The data shows how receptive most women are to these conversations and how they help women feel more confident about the choices they are making.’

She added that nurses and other professionals should not feel pressured to have all the answers immediately.

‘If a woman asks a question you do not feel able to answer, do not be afraid to say you will find out more or do the research with her,’ she said. ‘There is good information available from UKHSA, the Royal College of Midwives (RCM) and the Oxford Vaccine Project, which many parents see as independent of government.’

Dr Campbell also noted that true resistance to vaccination is relatively uncommon.

‘Most people simply have questions and feel reassured once they receive clear and honest answers,’ she said.

Other speakers at the event included nursing and midwifery immunisation leads at the UKHSA, as well as professional advisor, policy and public health at the Royal College of Midwives (RCM), Clare Livingstone, and national head of midwifery workforce at NHS England, Felipe Castro Cardona, and Yusra Osman, a student midwife who shared her own experience with vaccine hesitancy.

Checking status and offering vaccination

It was stressed during the webinar that vaccination discussions should be embedded throughout a patient’s maternity pathway, with any appointment or contact being an opportunity to check whether vaccines have been offered and accepted during the current pregnancy.

If a pregnant woman has not been vaccinated, healthcare professionals are encouraged to offer the vaccine at that point, rather than deferring the conversation.

Speakers from the RCM told attendees that by combining trusted evidence with compassionate communication, nurses and other healthcare professionals can play a central role in reducing vaccine hesitancy and protecting both pregnant women and their babies.

Speakers outlined how vaccines should be administered by appropriately trained healthcare professionals, as outlined in the Patient Group Direction (PGD), the UK legal framework that allows authorised professionals to supply or administer specified medicines to specific patient groups without individual prescriptions.

Evidence and national concern

Evidence presented during the session showed that vaccine confidence has improved in recent years. A report published this week by Imperial College London found a general decline in vaccine hesitancy during the 15 months following the Covid vaccine rollout.

Research published by Public Health Scotland in November also found that RSV vaccination during pregnancy reduces infant hospitalisations by around 80%.

Despite this, concerns remain about falling uptake. Giving evidence to the Covid inquiry last October, England’s chief nursing officer Duncan Burton said he was ‘terrified’ about declining vaccination rates among children and young people and ‘deeply concerned’ about vaccine hesitancy across the UK.

Current programmes and campaigns

Vaccination programmes continue to expand. Since January, GP practices have been offering the chickenpox vaccine as part of the expanded NHS childhood vaccination programme.

From this month, health visitors in some areas are set to offer vaccinations to children who have missed routine immunisations as part of a one-year pilot scheme.

The Department of Health and Social Care (DHSC) is also running its ‘Stay strong, get vaccinated’ campaign until mid-February, promoting flu, RSV and whooping cough vaccines for vulnerable groups, including pregnant women and young children.

Last August, England’s chief midwifery officer (CMO) Kate Brintworth urged eligible pregnant women to be vaccinated against RSV ahead of winter, as cases continued to rise.