Inequalities in maternal pertussis vaccination uptake: a cross-sectional survey of maternity units

Background This study aims to estimate pertussis vaccine uptake in pregnant women in England, describe timing of vaccine delivery and examine variations in uptake. Methods Cross-sectional survey of vaccine uptake in women delivering in maternity units in England. Variation in uptake described according to geography, maternal age, ethnicity and parity as reported by the midwife completing the survey. Results A total of 1325 surveys were returned, 85% of which (1128) contained information about vaccination. Vaccine uptake was 61.8% (95% CI: 56.8-66.5) and was higher in the White British ethnic group than any other (67.7%, 95% CI: 63.5 to 71.5). Uptake was higher outside London (65.3%, 95% CI: 61.1-69.3) than within London (31.0%, 95% CI: 24.9-38.0). Reported uptake was lower in areas of high deprivation, and in women of higher parity, observations that were not statistically significant in the multivariable model. Overall, 74% of women were vaccinated between 28 and 32 weeks. Conclusions Pertussis vaccine uptake in pregnant women varies significantly across the country and is affected by ethnicity, deprivation and parity. Variations should be addressed through service delivery models designed to reduce potential inequalities in infant protection.