Tag: Pregnancy

Boosting Vaccine Uptake in Pregnancy: What Works and What Doesn’t

Pregnancy is a time of anticipation and preparation. But it’s also a time when expectant mothers must be vigilant about their health — not just for themselves but for their unborn children as well. Vaccinations against COVID-19, influenza, and pertussis are vital during this period, yet many pregnant women hesitate to get these lifesaving shots. Let’s delve into recent research that sheds light on effective strategies to increase vaccine uptake among pregnant women.

Our study published in the Journal of Travel Medicine reviewed studies from January 2012 to December 2022, following the gold-standard PRISMA guidelines, to identify interventions that successfully increase vaccine uptake in pregnant women. The meta-analysis focused on three key diseases: COVID-19, influenza, and pertussis — all of which pose significant risks to both mother and child.

Key Findings

Out of 2,681 articles, 39 studies were relevant, comprising over 168,000 participants from nine different countries. Interestingly, while 15 of these were randomized controlled trials, the quality of evidence was strong in only 18% of the studies. Here’s what we found:

– For influenza, interventions modestly increased vaccine uptake, but the overall effect was small.

– For pertussis, the data showed no clear benefit from the interventions.

– There were no randomized controlled trials available for COVID-19 vaccine interventions during pregnancy.

The ‘Three Ps’ Approach

The interventions that were examined fell into three categories — patient, provider, and policy-level strategies.

Patient-Level: The most effective strategies at this level involved healthcare professionals giving clear recommendations, supplemented by text reminders and written information. Personalized face-to-face discussions that addressed concerns, debunked myths, and emphasized benefits were particularly effective.

Provider-Level: Educating healthcare professionals about the vaccines’ safety and importance, along with reminders to offer them as part of routine care, made a significant difference.

Policy-Level: Financial incentives, mandatory recording of vaccination data, and ensuring vaccines are readily available were key policy interventions that showed promise.


Our study indicates that while there’s some success in increasing influenza vaccinations, the overall impact of interventions is modest. Pertussis vaccine interventions didn’t show a clear benefit, and data on COVID-19 interventions is lacking.

What’s clear is the pivotal role of healthcare providers in educating and encouraging pregnant women to get vaccinated. There’s also untapped potential in mobile health technologies that could further promote vaccination during pregnancy.

The takeaway message is that a concerted effort combining clear communication, education, and policy support is essential to protect both mothers and their babies from vaccine-preventable diseases. As the medical community continues to explore and implement these interventions, the hope is to see a significant rise in vaccine uptake, ensuring safer pregnancies and healthier babies.

The Next Steps

For healthcare providers, the message is to continue the dialogue with expectant mothers, ensuring they have all the information they need to make informed decisions about vaccinations. For policymakers, the challenge is to create an environment where vaccinations are not just available but are actively and consistently promoted as part of prenatal care. And for expectant mothers, our study underscores the importance of discussing vaccinations with healthcare providers to ensure the healthiest possible start for their children.

Closing Thoughts

Vaccinations during pregnancy aren’t just a personal choice; they’re a public health priority. Our study provides a roadmap for increasing vaccine uptake — a mission that, if successful, could mean the difference between life and death for the most vulnerable among us.

Long term implications of Covid-19 in pregnancy

An article published in the BMJ by Allyah Abbas-Hanif, Neena Modi and myself discusses the long term implications of Covid-19 in pregnancy. Covid-19 in pregnancy increases the risk of severe complications for both mother and baby. The long term implications are unknown, but emerging signals warn of substantial public health threats. To counter high vaccine hesitancy in pregnancy we must end the default exclusion of pregnant women from the rigorous regulated drug development process and implement systematic, long term, population-wide surveillance of infected and non-infected people.

The full article can be read in the British Medical Journal.

Covid-19 treatments and vaccines must be evaluated in pregnancy

The numbers of pregnant and postpartum women in the UK admitted to hospital or intensive care because of Covid-19 peaked over the summer of 2021 Maternal mortality has reached concerning levels in 2021, with case fatality rates rising in the US, doubling in Brazil, and almost tripling in India since the beginning of the pandemic. In Brazil, health officials even suggested avoiding pregnancy to reduce risk during the pandemic.

Inconsistent messaging from authorities, driven by lack of trial data, has increased Covid-19 vaccine hesitancy among pregnant women. This, coupled with the increased transmissibility of new variants and relaxing of social distancing restrictions, contributed to the surge in hospital admissions seen in successive waves. Concerns around the longer term effect of Covid-19 post partum, including long Covid, cardiovascular complications of covid-19, and widening socioeconomic disparities are also mounting. Despite a desperate need for treatments, pregnant women continue to be left behind.

The full article can be read in the British Medical Journal.

DOI: https://doi.org/10.1136/bmj.n2377

A woman with a suspected viral rash in pregnancy

My article in the BMJ considers how doctors should approach the management of a woman with a suspected viral rash during pregnancy. Key points in the article include:

  • Consider country of origin in a woman presenting with a rash in pregnancy and ask for immunisation history.
  • Test for measles and rubella IgM and IgG antibodies, particularly if immunisation history is not clear.
  • Refer women with an active infection to the fetal medicine unit for fetal monitoring.

The full article can be read in the BMJ.