Acceptance and uptake of vaccines against tetanus, influenza, pertussis, and COVID-19 among pregnant and postpartum women in low- and middle-income countries: a systematic review and meta-analysis protocol.

Publication date: Sep 05, 2024

Pregnant women, fetuses, and neonates are particularly vulnerable to vaccine-preventable diseases (VPDs). These VPDs are associated with high morbidity and mortality among expectant mothers and their fetuses and neonates. Vaccination during pregnancy can protect the expectant mother from VPDs to which she may be especially vulnerable while pregnant. In addition, the passive transfer of maternal neutralizing immunoglobulin G (IgG) and secretory immunoglobulin A (IgA) also protects the fetus against congenital infections and may further protect the neonate from infection during the first few months of life. Despite this, coverage of recommended maternal vaccines remains suboptimal globally, especially in resource-constrained settings. Determinants of vaccine acceptance and uptake are frequently understudied in low- and middle-income countries (LMICs) and among specific groups such as pregnant and postpartum women. This proposed systematic review will assess the acceptance and uptake of vaccines against tetanus, influenza, pertussis, and COVID-19 among pregnant and postpartum women in LMICs. A Boolean search strategy employing common and medical subject heading (MeSH) terms for tetanus, influenza, pertussis, and COVID-19 vaccines, as well as vaccine acceptance, hesitancy, together with uptake, pregnancy, and postpartum, will be used to search electronic databases for relevant literature published between 2009 and 2024. Only studies conducted in LMICs that investigated determinants of acceptance, hesitancy, and uptake of tetanus, influenza, pertussis, and COVID-19 vaccines among pregnant and postpartum women will be eligible for inclusion in the review. The quality and the risk of bias of all eligible full-text articles will be assessed using the Joanna Briggs Institute’s (JBI) critical appraisal tools. This protocol proposes a systematic review and meta-analysis that aims to assess the uptake of maternal vaccines and to systematically appraise and quantify determinants of the acceptance and uptake of recommended vaccines during pregnancy and postpartum in LMICs. A better understanding of these factors and how they influence maternal vaccine decision-making will enable public health practitioners as well as global and national policymakers to design more effective interventions as we look towards expanding the scope and reach of maternal immunization programs.

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Concepts Keywords
Global Maternal immunization
Influenza Postpartum
Morbidity Vaccination in pregnancy
Mother Vaccine acceptance
Vaccination Vaccine uptake

Semantics

Type Source Name
disease MESH tetanus
disease MESH influenza
disease MESH pertussis
pathway KEGG Pertussis
disease MESH COVID-19
disease MESH vaccine-preventable diseases
disease MESH morbidity
disease MESH infections
disease IDO infection
disease IDO quality
drug DRUGBANK Tropicamide
pathway REACTOME Reproduction
disease MESH infectious diseases
drug DRUGBANK Tretamine
disease MESH immune tolerance
pathway REACTOME Infectious disease
disease IDO infectious disease
drug DRUGBANK Progesterone
drug DRUGBANK Isoxaflutole
disease IDO pathogen
disease MESH pregnancy outcomes
disease MESH death
drug DRUGBANK Coenzyme M
disease MESH smallpox
drug DRUGBANK Indoleacetic acid
disease IDO intervention
drug DRUGBANK Triethylenetetramine
disease IDO production
disease IDO country
disease IDO process
disease MESH live births
drug DRUGBANK Clostridium tetani toxoid antigen (formaldehyde inactivated)
disease MESH neonatal deaths
disease MESH diphtheria
pathway REACTOME Immune System
drug DRUGBANK L-Valine
pathway REACTOME Influenza Infection
disease MESH virus infection
disease MESH respiratory infections

Original Article

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