Factors influencing acceptance of vaccination during pregnancy in The Gambia and Senegal

Penda Johm; Nicole Nkoum; Amie Ceesay; El Hadji Mbaye; Heidi Larson; Beate Kampmann

doi:10.1016/j.vaccine.2021.05.068

Factors influencing acceptance of vaccination during pregnancy in The Gambia and Senegal

Vaccine. 2021 Jun 29;39(29):3926-3934. doi: 10.1016/j.vaccine.2021.05.068. Epub 2021 Jun 1.

Authors

Penda Johm¹, Nicole Nkoum², Amie Ceesay³, El Hadji Mbaye², Heidi Larson⁴, Beate Kampmann⁵

Affiliations

¹ Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, Gambia; The Vaccine Centre, Faculty of Infectious and Tropical Diseases, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom.
² Social Sciences and Health Division, Institute for Health Research, Epidemiological Surveillance and Training, IRESSEF, Diamniadio, Senegal.
³ Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, Gambia.
⁴ Vaccine Confidence Project, Faculty of Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
⁵ Vaccines and Immunity Theme, Medical Research Council Unit The Gambia at the London School of Hygiene and Tropical Medicine, Fajara, Gambia; The Vaccine Centre, Faculty of Infectious and Tropical Diseases, Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom. Electronic address: bkampmann@mrc.gm.

PMID: 34088509
DOI: 10.1016/j.vaccine.2021.05.068

Abstract

Background: Vaccination during pregnancy can protect pregnant women and their babies from infectious diseases. Tetanus vaccine, also known as tetanus toxoid, is the only vaccine given to pregnant women in The Gambia and Senegal, where it is given by antenatal care providers as part of the Expanded Programme on Immunization. A qualitative study was undertaken to explore factors influencing acceptance of vaccination during pregnancy in The Gambia and Senegal.

Methods: Focus group discussions and in-depth interviews were conducted across urban and rural settlements of The Gambia and Senegal. We explored the knowledge, attitudes, and perceptions of 152 women who were either pregnant or with an infant. NVivo 11 Qualitative Data Analysis Software was used for management and thematic analysis of the data.

Results: Women had sufficient knowledge of the need for tetanus vaccine from different information sources but insufficient knowledge of tetanus causes, signs and symptoms. Tetanus vaccine was perceived to be safe and side effects such as pain and swelling at site of injection did not deter uptake of future doses. Women overall had confidence in their sources of vaccine information and the health care workers who administered maternal vaccinations. Their willingness to accept vaccination during pregnancy was particularly influenced by their husbands and trusted healthcare workers. Women across all sites mentioned they would accept new maternal vaccines if they are sensitized beforehand about any potential risks and benefits to them and their babies.

Conclusion: Vaccine acceptance can be influenced by several factors including contextual, individual or group influences and vaccine or vaccination-specific issues. Women across The Gambia and Senegal are generally vaccine acceptors with confidence in the health care workers who vaccinate them and few concerns about maternal vaccines. Women's acceptance of vaccination during pregnancy is based on previous vaccination experiences and individual weighing of risks and benefits.

Keywords: Acceptance; Antenatal care; Maternal vaccination; Senegal; Tetanus vaccine; The Gambia.

MeSH terms

Female
Gambia
Humans
Infant
Patient Acceptance of Health Care
Pregnancy
Pregnant Women
Senegal
Tetanus* / prevention & control
Vaccination*