The VIP-IDEAL study aimed to understand the complex interplay between various factors influencing maternal vaccination uptake and informed the co-production of future health interventions, policy and practice.
The study included the conduct of semi-structured interviews and focus group discussions with pregnant or recently pregnant women, as well as interviews with healthcare workers and other stakeholders in socially and ethnically diverse Boroughs in London.
We have now completed recruitment, and have analysed and published the results. Please see 'Publications' for a lay summary of the results and the link to the scientific publication.
Short study title
Vaccination in pregnancy - ideas, experiences and attitudes, London (VIP-IDEAL)
Full study title
Maternal vaccination uptake in socially and ethnically diverse communities: a qualitative study among pregnant/post-partum women and service providers in London to inform the co-production of future health interventions
Study purpose
We wanted to find out what types of vaccines women were offered during pregnancy and what they thought about these different vaccines, including vaccines against whooping cough, flu and Covid-19.
In some areas uptake of one or all of these vaccines was low, and we wanted to find out what the reasons were and if people had any suggestions on things that could be improved in the future, such as the way these vaccines were offered to pregnant women. We particularly wanted to make sure that we got the views of people from a range of social and ethnic backgrounds to ensure that the experiences and concerns of a wide range of people living in South London were understood and considered in the future.
The information from this study could help us and other researchers to think of ways to develop or improve health interventions and programmes together with different service providers and members of the public. The research may also influence future decisions regarding new vaccines that are currently being developed.
Research activities
Research activities included impartial and confidential semi-structured interviews and focus group discussions conducted in person or remotely (via phone or video call) among the following three participant groups:
1) Pregnant (2nd or 3rd trimester) or recently pregnant women living or receiving healthcare in socially and ethnically diverse areas in South London
- Interviews (lasting about 45-60 minutes)
- Group discussions (lasting about 45-90 minutes)
2) Healthcare professionals (incl. GPs, nurses, midwives) working in South London
- Interviews (lasting about 20-40 minutes)
3) Other relevant stakeholders (incl. health managers, NGO staff and local community leaders) in South London
- Interviews (lasting about 20-40 minutes)
- (Informal discussions)
Participants receive £20 as a thank you for taking part.
For more information and details, please see the participant information sheets in the ‘Get involved’ section.
Funding and approvals
The study was funded by the Wellcome Trust (a charitable foundation with focus on health research) through an LSHTM Institutional Strategic Support Fund (ISSF) Pump Priming Grant (Wellcome ISSF Pump Priming Grant reference: 204928/Z/16/Z).
We have obtained approval for the study from the NHS Health Research Authority, the London - South East NHS Research Ethics Committee and the LSHTM Research Ethics Committee.
The VIP-IDEAL study team included researchers from the Faculty of Epidemiology and Population Health and the Faculty of Public Health and Policy. We also received support from the NIHR Clinical Research Network South London.
Sima
Berendes
Assistant Professor
Caroline Free
Sandra
Mounier-Jack
Professor of Health Systems and Policy
Oyinkansola
Ojo-aromokudu
Research Student - MPhil/PhD - Public Health & Policy
We have now completed recruitment, and have analysed and published the results. Please see 'Publications' for a lay summary of the results and the link to the scientific publication.
If you are interested in hearing more about this study or related studies please get in touch.
Please see below for the eligibility criteria and further information for the different groups of people who had been eligible to participate in the study.
Group 1 (pregnant/recently pregnant women)
We were looking for women who:
- are pregnant (2nd or 3rd trimester) or have recently given birth to a baby (after April 2021) AND
- live and/or receive healthcare in socially and ethnically diverse communities in South London AND
- are aged ≥ 16 years
For more information, please see:
- Participant Information Sheet (Group 1)
- Informed Consent Form for interviews (Group 1)
- Informed Consent Form for focus group discussions (Group 1)
Group 2 (healthcare providers)
We were looking for:
- Healthcare providers, including GPs, nurses and midwives who regularly provide services to pregnant or post-partum women from/in socially and ethnically diverse communities in South London.
For more information, please see:
- Participant Information Sheet (Group 2 and 3)
- Informed Consent Form (Group 2 and 3)
Group 3 (other stakeholders)
We were looking for:
- Other relevant local stakeholders, including health managers, NGO staff and local community leaders who may have an influence on the current or future uptake of maternal vaccinations in South London
For more information, please see:
- Participant Information Sheet (Group 2 and 3)
- Informed Consent Form (Group 2 and 3)
The results of our qualitative study were published in a scientific journal in July 2023.
Access the (open access).
Please see a lay summary of our results below.
Short study name (acronym)
Vaccination in pregnancy - ideas, experiences and attitudes, London (VIP-IDEAL)
Who conducted this study?
The study was conducted by a research team from the London School of Hygiene and Tropical Medicine at the University of London.
Where and when was the study conducted?
The study was conducted in South London in 2022.
Why was the study done?
The researchers wanted to find out which vaccines women were offered during pregnancy and what they thought about them. They looked at vaccines against whooping cough, flu and Covid-19.
In some areas, only few people took these vaccines during pregnancy, and the researchers wanted to find out why. They also wanted to find out how things can be improved in the future.
The researchers wanted to hear from people from different social and ethnic backgrounds. This was to ensure that the experiences and worries of different types of people living in South London are understood and considered in the future, including from those who did not get vaccines during pregnancy.
Who took part in this study?
Both healthcare service users and providers took part:
- A total of 38 pregnant or recently pregnant women
- A total of 20 service providers, including 12 midwives, 2 family doctors, 3 pharmacists and 3 other providers
What happened during the study?
The researchers conducted interviews with 31 healthcare service users and 20 providers and a group discussion with seven service users. Participants could choose whether to be interviewed over the phone, via video conferencing, or in person. The interviews lasted about 20 to 90 minutes.
With consent of participants, the interviews and group discussion were audio-recorded and analysed.
What were the overall results of the study?
The pregnant or recently pregnant women in the study said they took either all, none, or some of the vaccines. The most common vaccine they took was for whooping cough, followed by flu and only few took the Covid-19 vaccine. Some women were unsure if they were offered the vaccines, while a few others forgot them or could not get them. A few were advised against the Covid-19 vaccine by their midwives.
Many people in the study, including midwives, said that it was up to the pregnant women to do their ‘own research’ about the vaccines and then decide if they wanted them. But many women felt they did not get enough information from midwives about where and when to get the vaccines and how safe and important they are. So they looked for information elsewhere, including online and on social media with the risk of getting wrong information. This made them more worried about vaccine side effects, especially for Covid-19.
Not just the pregnant women, but also some of the healthcare workers were confused when the government changed its advice in April 2021 and said pregnant women should get the Covid-19 vaccines. Some participants found that healthcare workers themselves did not have enough information about the vaccines and needed more training. Many participants found that we need more research to find out if new vaccines have any long-term effects on pregnant women or their babies. Many healthcare workers said that they did not have enough time to discuss vaccines with pregnant women.
Some also said that the computer systems were not good for reminding people about vaccines and keeping track of who got them or what was discussed. Most pregnant women were told about a pregnancy app, but were not told how to use it and did not know it had information about vaccines. Some pregnant women preferred to have information on paper instead of using apps. Some participants also spoke about language problems.
Overall, many participants talked about how the healthcare was organised and how that affected the decisions pregnant women made about vaccines and how to get them. Some participants also discussed where vaccines should be offered, and a few suggested that more vaccines should be offered in pharmacies. Many participants had ideas on how to make things better, for example, giving pregnant women more personalised information in different languages.
How has this study helped patients and researchers?
During the quite long interviews participants from different ethnic backgrounds were able to share their experiences and thoughts on vaccinations in pregnancy during the Covid-19 pandemic. Not everyone thinks the same, and the people who took part in the study might be different from others. We noticed, for example, that the midwives who took part were more pro vaccine than some of the midwives mentioned by the pregnant women. Nevertheless, it was very helpful to hear from both sides, including service providers and clients.
The information from this study can help researchers to improve health programmes with the help of healthcare providers and the public. It might also influence decisions about new vaccines that might become available in the future.
Where can I learn more about this study?
You can access the .
Thank you!
We would like to thank all participants again for taking part in this study. We would also like to thank the NIHR Clinical Research Network for helping us with participant recruitment and the Wellcome Trust (a charity) for funding this study.
Please note that the views given here are those of the authors and not necessarily those of the funders or sponsor of the study. This summary was written on 21 July 2023. It includes only results from one single study. Other current or future studies may find different results.