Understanding factors that influence the decision to be vaccinated against influenza and pertussis in pregnancy: A qualitative study

Antonia Arreciado Marañon, María Isabel Fernández-Cano*, Laura Montero Pons, Maria Feijoo-Cid, Azahara Reyes-Lacalle, Rosa Cabedo-Ferreiro, Josep Maria Manresa Dominguez, Gemma Falguera-Puig

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

2 Citations (Scopus)


Aims and objectives: To identify how pregnant women perceive pertussis and influenza and the factors that influence their decision to be vaccinated.

Background: Suffering from influenza during pregnancy increases complications in the pregnant woman, foetus and newborn. Pertussis in children under six months of age causes severe complications. Maternal vaccination against influenza and pertussis is effective and safe. However, vaccination rates are insufficient.

Design: We conducted a qualitative descriptive study, using semi-structured interviews. This research adheres to the COREQ guidelines and checklist.

Methods: We carried out 18 semi-structured face-to-face interviews with pregnant women, using intentional sampling and thematic analysis.

Results: We identified an overarching theme, 'factors that influenced participants' decision to be vaccinated or not', which was composed of four subthemes that were in turn made up of 12 categories. The factors that influenced participants' decision to be vaccinated against influenza and pertussis were related to their knowledge of and their perception of risk for these diseases. Participants perceived the risk of pertussis to be greater, and they focused their concern on the newborn. The recommendations and convictions of nurse-midwives were the most important factors encouraging vaccination. Participants trusted their nurse-midwives and most reported that they would have been vaccinated if their midwife had recommended it. Other factors were linked to lack of information, fear and concerns about economic interests.

Conclusions: The convictions and actions of the nurse-midwife in recommending vaccination to pregnant women are decisive. Strategies to improve vaccination rates should be directed to helping health professionals understand how their practice affects the final decision of pregnant women.

Relevance to clinical practice: Understanding the factors that limit vaccination rates among pregnant women provides valuable information to nurse-midwives that can help to improve vaccination strategies and practices. Increased maternal vaccination rates would reduce morbidity and mortality among pregnant women and newborns.
Original languageEnglish
Pages (from-to)1531-1546
Number of pages16
JournalJournal of Clinical Nursing
Issue number11-12
Early online date2021
Publication statusPublished - 22 May 2022


  • immunisation
  • influenza vaccination
  • maternal health
  • midwifery
  • pertussis vaccination
  • pregnant vaccine
  • prenatal care
  • qualitative research

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