Evidence map›Paper›PMID 37934788›Full record

SynthesisJournal of travel medicine2023

Interventions to increase vaccination against COVID-19, influenza and pertussis during pregnancy: a systematic review and meta-analysis.

Mohammad S Razai, Rania Mansour, Lucy Goldsmith, Samuel Freeman, Charlotte Mason-Apps, Pahalavi Ravindran, Pavan Kooner, Sima Berendes, Joan Morris, Azeem Majeed and 3 more

Registry-linked trialOpen access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of travel medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06815250 (Effectiveness of the Influenza and Tdap), which is not on this map. Cited by 21 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 2 pooled it
7.7field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06815250 narecruitingnot on this mapstarted 2026, after this paper: background citation

Effectiveness of the Influenza and Tdap (Tetanus, Diphtheria, Acellular Pertussis) Vaccination Educational and Learning Module (InTroDuce-Programme) in Improving Knowledge and Future Uptake of Vaccination Among Pregnant Mothers in Primary Care Clinics: A Randomised Control Trial Secondary IDs

TypeinterventionalSponsorUniversiti Putra MalaysiaRan2026 to 2026Enrolled351ConditionsVaccination Uptake, Knowledge, Tetanus, Diphtheria and Acellular Pertussis Vaccination, InfluenzaArmsInfluenza and Tdap Vaccination Educational and Learning Module
3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.

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  19. Review
  20. Vaccination in pregnancy.Frontiers in global women's health · 2024
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 5 institutions in 1 country.

Mohammad S RazaiPopulation Health Research Institute, St George's University of London, London, UK.
Rania MansourPopulation Health Research Institute, St George's University of London, London, UK.
Lucy GoldsmithPopulation Health Research Institute, St George's University of London, London, UK.
Samuel FreemanPrimary Care Unit, University Hospitals Sussex NHS Foundation Trust, Sussex, UK.
Charlotte Mason-AppsPopulation Health Research Institute, St George's University of London, London, UK.
Pahalavi RavindranDepartment of Respiratory Medicine, University Hospitals of Leicester NHS Foundation Trust, Leicester, UK.
Pavan KoonerWest London NHS Foundation Trust, London, UK.
Sima BerendesDepartment of Population Health, London School of Hygiene and Tropical Medicine, London, UK.
Joan MorrisPopulation Health Research Institute, St George's University of London, London, UK.
Azeem MajeedDepartment of Primary Care and Public Health, Imperial College London, London, UK.
Michael UssherPopulation Health Research Institute, St George's University of London, London, UK.
Sally HargreavesPopulation Health Research Institute, St George's University of London, London, UK.
Pippa OakeshottPopulation Health Research Institute, St George's University of London, London, UK.
St George's, University of London · GBImperial College London · GBLondon School of Hygiene & Tropical Medicine · GBUniversity Hospitals of Leicester NHS Trust · GBUniversity Hospitals Sussex NHS Foundation Trust · GB

Funding

Academy of Medical Sciences SBF005\1111Medical Research Council MR/N013638/1
6 · The paper itself

Abstract

backgroundPregnant women and their babies face significant risks from three vaccine-preventable diseases: COVID-19, influenza and pertussis. However, despite these vaccines' proven safety and effectiveness, uptake during pregnancy remains low.

methodsWe conducted a systematic review (PROSPERO CRD42023399488; January 2012-December 2022 following PRISMA guidelines) of interventions to increase COVID-19/influenza/pertussis vaccination in pregnancy. We searched nine databases, including grey literature. Two independent investigators extracted data; discrepancies were resolved by consensus. Meta-analyses were conducted using random-effects models to estimate pooled effect sizes. Heterogeneity was assessed using the I2 statistics.

resultsFrom 2681 articles, we identified 39 relevant studies (n = 168 262 participants) across nine countries. Fifteen studies (39%) were randomized controlled trials (RCTs); the remainder were observational cohort, quality-improvement or cross-sectional studies. The quality of 18% (7/39) was strong. Pooled results of interventions to increase influenza vaccine uptake (18 effect estimates from 12 RCTs) showed the interventions were effective but had a small effect (risk ratio = 1.07, 95% CI 1.03, 1.13). However, pooled results of interventions to increase pertussis vaccine uptake (10 effect estimates from six RCTs) showed no clear benefit (risk ratio = 0.98, 95% CI 0.94, 1.03). There were no relevant RCTs for COVID-19. Interventions addressed the 'three Ps': patient-, provider- and policy-level strategies. At the patient level, clear recommendations from healthcare professionals backed by text reminders/written information were strongly associated with increased vaccine uptake, especially tailored face-to-face interventions, which addressed women's concerns, dispelled myths and highlighted benefits. Provider-level interventions included educating healthcare professionals about vaccines' safety and effectiveness and reminders to offer vaccinations routinely. Policy-level interventions included financial incentives, mandatory vaccination data fields in electronic health records and ensuring easy availability of vaccinations.

conclusionsInterventions had a small effect on increasing influenza vaccination. Training healthcare providers to promote vaccinations during pregnancy is crucial and could be enhanced by utilizing mobile health technologies.

Indexed as

COVID-19Influenza, HumanInfluenza VaccinesWhooping CoughFemaleHumansPregnancyVaccinationInfluenza Vaccinesantenatal carematernal healthmaternal immunizationpublic policystrategiesvaccine confidenceVaccine hesitancy

Identifiers

PMID37934788
PMCPMC10755181
OpenAlexW4388452098

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.