INCREASING VACCINATION UPTAKE IN PREGNANCY: A MIDWIFE-LED APPROACH AT GEORGE ELIOT HOSPITAL

The project aimed to increase vaccination uptake during pregnancy at George Elliot Hospital (GEH) by providing dedicated midwife-led vaccination clinics for whooping cough, flu, and Covid-19. The initiative was designed to address barriers to accessing vaccinations, particularly for those in more deprived areas. Since the introduction of the dedicated midwife, uptake has significantly increased, with a 20% rise in flu vaccinations and a 25% rise in whooping cough vaccinations.

Why was change needed? 

Vaccination during pregnancy is crucial for protecting both mothers and their unborn children from preventable diseases such as whooping cough, flu, and Covid-19. However, uptake rates for these vaccinations at George Elliot Hospital (GEH) were far below national targets in 2023, with only 32.8% of pregnant women receiving the whooping cough vaccine and 30% receiving the flu vaccine, both of which fell short of national targets (60% for whooping cough and 75% for flu). This highlighted the need for a tailored approach to increase engagement, particularly in the local community where barriers such as low socio-economic status and limited access to healthcare services can hinder vaccination uptake.

North Warwickshire, where GEH is located, includes many areas of high deprivation (known as Core20), which means that many women face challenges in accessing healthcare services due to financial constraints or logistical difficulties, such as the cost of travel. The project aimed to overcome these barriers by offering a dedicated midwife-led service to deliver vaccinations in both hospital and community settings, ensuring that women have more accessible options for receiving these vital vaccines during pregnancy.

What we did

The project involved the appointment of a dedicated midwife to deliver vaccination clinics both at George Elliot Hospital and in the local community, with a primary focus on increasing uptake of the whooping cough vaccine. This vaccine requires an additional appointment, which can present a barrier for pregnant women, particularly those living in more deprived areas. The midwife’s role was to provide tailored advice to patients about the importance of vaccinations and address any concerns they may have, such as safety and potential side effects.

Data from the first six months of the project shows positive results, with flu vaccination uptake increasing by 20% following the midwife’s involvement, despite the timing being late in the flu season. The uptake of the whooping cough vaccine also steadily increased, with some months seeing nearly triple the uptake compared to previous months, and an overall increase of 25%.

The project also identified key demographic factors affecting uptake, with the highest rates of decline among women aged 18-30 and those from white British and Eastern European backgrounds. Concerns regarding vaccine safety and side effects were the most common reasons for refusal, even after discussions with healthcare practitioners.

What’s next? 

The project will continue to review data to further develop the vaccination service, focusing on increasing access to appointments both in the hospital and the community. The team will work on pre-arranging parent education sessions and establishing community clinics to reach populations with the lowest vaccination uptake. Collaboration with local partners will be essential to engage these groups effectively, and preparations for the next flu season will be prioritised to maintain momentum.