Maternal vaccination in the NHS (MAVIS) Study

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‌‌A mixed methods approach to improving antenatal immunisation

We are currently recruiting maternity professionals in the following areas. Please scroll down for more information.

This research aims to identify how NHS maternity services can be supported to improve pertussis and other vaccination delivery to pregnant women, aiming to reduce inequities between demographic groups and NHS areas.

Pertussis is widespread, highly contagious and serious for new-born babies. Vaccination is recommended for pregnant women to give newborn babies immunity from birth until they are old enough for their own vaccination. 30% pregnant women in the UK do not receive the vaccine and more miss out on the influenza vaccine. Coverage is highly variable across regions of the country, and Black and ethnic minority women are particularly likely to miss out. The reasons for these differences are not clear. Maternal immunisation against Covid-19 is recommended, and more maternal vaccines are being developed nationally and globally. Understanding how to ensure effective delivery of these programmes is important.

The MAVIS Study involves several projects designed to explore maternal vaccination in England, to identify what could be improved:

PROJECT 1: WHO IS MISSING OUT?

Retrospective cohort study using national primary care record data (CPRD) to explore predictors/risk factors for not being vaccinated in pregnancy - i.e. to describe the groups of women who are likely to miss out on their pregnancy vaccines. Collaborating with researchers at the London School of Hygeine and Tropical Medicine.

PROJECT 2: THE MATERNITY STAFF PERSPECTIVE

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National survey with healthcare professionals at maternity services in NHS areas with the highest and lowest maternal pertussis vaccination coverage (aiming for 500 participants).
- Survey development used theoretical frameworks of behavioural determinants, clinical advisory group consultation and think-aloud user-testing
- Quantitative and qualitative analysis of responses will identify barriers and facilitators to maternity-service delivery of vaccination.
In-depth interviews with healthcare professonals will supplement survey data
Project 2 includes an additional commissioner survey to map vaccination provision across all the maternity services/trusts in England

Project 2 has gained approval from the University of Bristol's Faculty of Health Science Research Ethics Committee (ref 9397)

PROJECT 3: THE PARENT PERSPECTIVE

National survey with recently pregnant women, especially those who did not receive maternal pertussis vaccination (aiming for 500 participants)
- Survey development used theoretical frameworks of behavioural determinants, patient and public involvement group consultation and think-aloud user-testing
- Quantitative and qualitative analysis of responses will identify barriers and facilitators to women's uptake of vaccination.
In-depth interviews with recently pregnant women (and their partners) will supplement survey data.

Project 3 has gained approval from the HRA and Health and Care Research Wales and the London-Fulham Research Ethics Committee (ref 22/PR/1166) and will launch in 2023

PROJECT 4: RECOMMENDATIONS

Working with clinical and public advisory groups, the findings will be used to produce intervention recommendations to increase the number of pregnant women receiving the whooping cough vaccine across maternity services and demographic groups, and to inform other mother and child vaccine programmes.

Patient and public involvement (PPI):

Consultation and codesign with the following advisory groups is embedded throughout the project to help design the research and interpret findings:

Parent advisory group (mothers from underserved communities and of Black/minoritised ethnicities)
Clinical advisory group (NHS midwives and maternity professionals)

‌

Dr Emma Anderson, Research Fellow‌

Contact: mavis-study@bristol.ac.uk

SUPERVISORY TEAM:

Dr Christie Cabral (lead)

Professor Adam Finn

Professor Pete Blair

Professor Jenny Ingram

Acknowledgements:

The MAVIS Study is funded by the National Institute for Health Research (NIHR doctoral fellowship NIHR300914). The views expressed are those of the author and not necessarily those of the NIHR or the Department of Health and Social Care.

The study is hosted jointly across the Centre for Academic Child Health (CACH) and the Health Protection Research Unit in Behavioural Science and Evaluation (HPRU-BSE). The University of Bristol is the study sponsor.