(1137) Strategies to increase vaccine uptake in pregnant and breastfeeding individuals: a scoping review

To identify and map strategies to increase vaccine uptake in pregnant and breastfeeding populations with the aim of informing practice and strategies to increase vaccination uptake in this group.

Study Design: We conducted a scoping review of the literature wherein we used a comprehensive search algorithm to identify relevant publications indexed in six electronic databases. We included studies that reported on pregnant and breastfeeding individuals, examined an intervention to improve vaccine uptake, and reported outcomes related to change in vaccine attitude, perspective, intention, behaviour, or uptake. Interventions were mapped using a five-level social ecological framework (intrapersonal, interpersonal, institutional, community, and policy level) or as bundled interventions, when strategies targeted multiple levels.

Results: The search yielded 5458 publications after deduplication, of which 63 were included in the final review. Included studies reported mostly on the uptake of influenza, pertussis, tetanus toxoid and COVID-19 vaccines in 17 high- and middle-income countries. Studies varied in terms of design, sample size, scope and study output (Table 1) and described interventions corresponding to all levels of the social ecological framework (Figure 1). Most studies (33.3%) described using bundled interventions, although intrapersonal (31.7%) and institutional (15.9%) strategies were also widely employed. While the reported uptake (5% to 93%) varied based on comparator group, vaccine type, country and intervention(s), most strategies were deemed effective when implemented in the context of experimental and observational studies.

Conclusion:

The published literature points to several successful strategies for increasing vaccine uptake among pregnant and breastfeeding individuals. Incorporating these strategies into guidelines and protocols could increase the uptake of routinely recommended and new (COVID-19) vaccines in this population.