Data analysis of investigation of Bordetella pertussis booster vaccine acceptance among pregnant women living in Mexico City Public

Abstract

OBJECTIVE : Adult booster vaccination against pertussis can help prevent severe infections in young infants. We examined influences on pertussis booster vaccine acceptance among pregnant women in Mexico City.

METHODS : We conducted a cross-sectional survey, recruiting convenience samples of pregnant women receiving prenatal care from three public clinics between March and May 2012. Our primary outcome was intention to accept pertussis vaccination during pregnancy. We examined socio-demographic factors, vaccination history, pertussis knowledge, perceptions of vaccine information sources and other potential influences on vaccine decision-making.

RESULTS : A total of 402 pregnant women agreed to participate, of which 387 (96%) provided their intention to accept or decline pertussis vaccination. Less than 1% received a recommendation for pertussis vaccination during pregnancy. Among respondents, 222 (57%) intended to accept a pertussis booster vaccine, but more than 80% would accept vaccination if recommended by an obstetrician-gynecologist. In multivariate analysis, rating doctors and nurses as good sources of vaccine information, and having ever heard of pertussis, were independently associated with vaccine acceptance (P<0.05). Interaction was detected between age and perceptions of religious leaders as vaccine information sources (P=0.03). Among health belief model dimensions, perceived disease susceptibility and vaccine safety for pregnant women, and disease severity for newborns, were independently associated with pertussis vaccine acceptance (P<0.05).

CONCLUSION : Promoting patient awareness about pertussis disease and vaccine safety, and encouraging obstetrical providers to recommend Tdap, may increase vaccine uptake among pregnant women.

Table of Contents

Chapter I : Literature Review............................................................................... 1

Literature Review......................................................................................... 2 References................................................................................................ 21 Chapter II: Manuscript...................................................................................... 35 Introduction.............................................................................................. 36

Materials & Methods.................................................................................... 37

Results..................................................................................................... 40 Discussion................................................................................................. 44 Tables...................................................................................................... 48 Figures..................................................................................................... 56 References................................................................................................ 61

Chapter III: Public Health Implications............................................................... 64

Public Health Implications............................................................................. 65

Appendices...................................................................................................... 67

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Global Epidemiology - MPH & MSPH
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Epidemiology
Mot-clé	Mexico Tdap pregnancy pertussis vaccine immunization
Committee Chair / Thesis Advisor	Omer, Saad B, Emory University
Committee Members	Esteves, Alejandra, National Center for Child and Adolescent Health, Mexico City, Mexico
Partnering Agencies	Non-US governmental agency (e.g., Minister of Health in Haiti)

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