背景:孕妇,胎儿,和新生儿特别容易受到疫苗可预防的疾病(VPD)。这些VPD与孕妇及其胎儿和新生儿的高发病率和死亡率相关。怀孕期间的疫苗接种可以保护准妈妈免受VPD的侵害,她在怀孕期间可能特别容易受到VPD的侵害。此外,母体中和免疫球蛋白G(IgG)和分泌型免疫球蛋白A(IgA)的被动转移也可以保护胎儿免受先天性感染,并可能进一步保护新生儿在出生后最初几个月免受感染.尽管如此,推荐的孕产妇疫苗的覆盖率在全球范围内仍然欠佳,尤其是在资源受限的环境中。在低收入和中等收入国家(LMICs)以及孕妇和产后妇女等特定群体中,疫苗接受和吸收的决定因素经常被研究不足。这项拟议的系统审查将评估破伤风疫苗的接受度和使用情况,流感,百日咳,和COVID-19在LMIC的孕妇和产后妇女中。
方法:一种布尔搜索策略,采用破伤风的常见和医学主题标题(MeSH)术语,流感,百日咳,和COVID-19疫苗,以及疫苗接受度,犹豫,连同摄取,怀孕,产后,将用于搜索2009年至2024年间发表的相关文献的电子数据库。只有在LMIC中进行的研究调查了接受的决定因素,犹豫,和破伤风的摄取,流感,百日咳,孕妇和产后妇女的COVID-19疫苗将有资格纳入审查。将使用JoannaBriggsInstitute(JBI)的关键评估工具评估所有符合条件的全文文章的质量和偏差风险。
结论:该方案提出了一项系统评价和荟萃分析,旨在评估孕妇疫苗的摄取情况,并系统地评估和量化LMIC在怀孕和产后接受和摄取推荐疫苗的决定因素。更好地了解这些因素及其如何影响孕产妇疫苗决策,将使公共卫生从业人员以及全球和国家政策制定者能够设计更有效的干预措施,因为我们希望扩大孕产妇免疫计划的范围和覆盖面。
BACKGROUND: 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.
METHODS: 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.
CONCLUSIONS: 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.