title: Experiences and perspectives of mothers of the pertussis vaccination programme in London.
abstract: BACKGROUND
  In 2012, a pertussis outbreak prompted a national vaccination programme for pregnant women, which provides passive protection for infants. Vaccine uptake in London is consistently lower than elsewhere in the UK. There are few studies looking at the reasons why pregnant women accept or refuse pertussis vaccination. Therefore, this study aimed to gain a better understanding of London women's views and experiences, to identify how services might be improved.
  
  
  METHODS
  Cross-sectional qualitative semi-structured interviews study.
  
  
  METHODS
  Purposive sampling of four London boroughs was made, taking boroughs in different geographical locations, with varying levels of deprivation and pertussis vaccine uptake. Participants were recruited through baby clinics and interviews conducted covering knowledge about pertussis, the vaccine, information given during pregnancy, factors influencing decision-making, experience of vaccination, future intentions in another pregnancy and recommendations for improving uptake. A thematic analysis approach was used.
  
  
  RESULTS
  A total of 42 interviews were conducted. Five main themes were identified: (1) lack of discussion about pertussis; (2) desire to protect the baby; (3) trust in health professionals; (4) convenience of vaccination; and (5) help navigating 'busyness of pregnancy'. This study found that, if offered, most women would accept vaccination. Although vaccination through the general practitioner was convenient, more options for vaccination, such as through antenatal clinics, might increase uptake. Despite usage of the internet to look up medical information, women wanted to discuss vaccination with their midwives or general practitioners. Women wanted a simple pregnancy 'checklist' to help ensure that they had received all recommended aspects of antenatal care including vaccination.
  
  
  CONCLUSIONS
  Poor uptake of vaccine is not always due to lack of demand or active refusals. Service providers have an important role to play in actively promoting vaccination services, ensuring women have access to the information they require and in increasing the availability and access to vaccination programmes.
authors.affiliation: NHS England (London Region), 4th Floor, Southside, 105 Victoria Street, London, SW1E 6QT, UK.
authors.forename: C G
authors.initials: CG
authors.lastname: Winslade
authors.affiliation: NHS England (London Region), 4th Floor, Southside, 105 Victoria Street, London, SW1E 6QT, UK. Electronic address: catherine.heffernan@nhs.net.
authors.forename: C M
authors.initials: CM
authors.lastname: Heffernan
authors.affiliation: NHS England (London Region), 4th Floor, Southside, 105 Victoria Street, London, SW1E 6QT, UK.
authors.forename: C J
authors.initials: CJ
authors.lastname: Atchison
mesh_terms: D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017589:Immunization Programs; D008131:London; D008875:Middle Aged; D009035:Mothers / Q000523:psychology* / Q000706:statistics & numerical data; D010567:Pertussis Vaccine / Q000008:administration & dosage*; D015397:Program Evaluation; D036301:Qualitative Research; D014917:Whooping Cough / Q000517:prevention & control; D055815:Young Adult
chemical_list: D010567:Pertussis Vaccine
keywords: Improving pertussis vaccine uptake; Maternal pertussis vaccination programme; Maternal vaccination; Patient experience