Maternal vaccination uptake: moving research into practice

Vaccination during pregnancy protects two patients at once. Immunisation can reduce a pregnant person’s risk of severe illness while transferring antibodies across the placenta to provide early protection for a newborn, before the infant is eligible for many routine vaccines. Influenza, pertussis, COVID-19 and, where recommended, respiratory syncytial virus vaccination are therefore important parts of antenatal care.

Yet evidence of effectiveness does not automatically produce high coverage. Uptake is shaped by the timing of antenatal visits, confidence in health advice, access to services, cultural safety, previous experiences with healthcare and the clarity of conversations between clinicians and families. Maternal vaccination uptake is consequently a translation challenge: research findings must become reliable, acceptable actions across hospitals, general practice, community services and homes.

Collaborative networks have a valuable role in this process. The Brisbane Diamantina Health Partners model brings research organisations, universities and health services together, creating opportunities to test practical interventions, measure outcomes and share what works across Queensland.

Why pregnancy vaccination requires a systems approach

A missed vaccination may reflect several connected causes rather than a single decision. A patient might attend a late booking appointment, receive inconsistent advice from different clinicians, encounter a service without suitable stock or be unsure whether vaccination is safe during pregnancy. Analysing these points along the care pathway gives researchers a more useful picture than simply reporting an overall coverage rate.

Local data can reveal where the process breaks down. Health services may compare vaccination status by trimester, postcode, language, age, Aboriginal and Torres Strait Islander status, referral pathway or type of antenatal provider. Used carefully, this information can identify inequities without labelling communities as difficult to reach.

Research teams should pair quantitative findings with interviews and co-design. Pregnant people, partners, midwives, obstetricians, general practitioners, pharmacists, Aboriginal health workers and community organisations can explain why a well-designed policy may fail in daily practice. Their insight helps distinguish misinformation from legitimate concerns about access, cost, side effects or trust.

Turning evidence into a dependable care pathway

The most effective interventions usually make vaccination part of routine antenatal care rather than treating it as an optional extra conversation. Electronic prompts, standing orders, stock checks and clear responsibility for follow-up can reduce the chance that every appointment depends on individual memory.

A consistent recommendation from trusted clinicians matters. Midwives and doctors can use plain language to explain the benefits, likely side effects and recommended timing, while acknowledging uncertainty where guidance is evolving. A respectful conversation should leave room for questions and support informed consent rather than relying on pressure.

Translation also requires operational detail. Services need protocols for screening, documentation, observation after vaccination, reporting adverse events and arranging catch-up doses when an appointment is missed. Linking maternity records with immunisation registers, where permitted and appropriately governed, can support reminders and reduce duplication.

Matching strategies to barriers

Different populations may need different delivery models. A tertiary hospital might improve uptake through an antenatal vaccination clinic, while a rural service may benefit from outreach, pharmacy collaboration or scheduled immunisation days. Digital reminders can help some families, but telephone contact, interpreters and community-based support may be more effective for others.

Communication materials should be tested with the people they are intended to reach. Translated resources need more than literal conversion; they should reflect local terminology, family decision-making and culturally safe ways of discussing pregnancy and prevention. Aboriginal and Torres Strait Islander-led approaches should be developed with appropriate governance and community authority.

Evaluation should examine both reach and experience. A programme that raises overall coverage but leaves some communities behind requires further adaptation. Measures such as timeliness, equity, patient confidence, staff workload, vaccine wastage and adverse event reporting can show whether an intervention is sustainable.

Building trust through transparent communication

Vaccine confidence grows when people receive timely, consistent and credible information. Antenatal clinicians can explain how safety surveillance works, what is known about maternal and infant outcomes, and which symptoms after vaccination are expected. They should also correct misinformation without dismissing the emotions or experiences behind it.

Trust is strengthened when communication is two-way. Asking what a patient has heard, what worries them and who influences health decisions allows the clinician to respond to the actual concern. A brief conversation may be enough for one person, while another may need written information, a follow-up appointment or discussion with a preferred support person.

Public-facing messaging should avoid overstating benefits or using fear as the main motivator. Research translation is stronger when it communicates uncertainty honestly and updates resources as recommendations change. Health services can direct families to reliable state and national guidance while ensuring that the explanation is relevant to the individual pregnancy.

Making implementation measurable and ethical

Implementation science offers practical tools for moving from a promising intervention to routine care. Teams can map the care process, identify barriers, pilot a change on a small scale, review data and refine the model before wider adoption. This approach recognises that context matters: a strategy successful in an urban maternity service may require redesign in a regional or community setting.

Governance should be built into the work from the beginning. Data access, consent, privacy, cultural governance, reporting responsibilities and community benefit need clear agreements. Partnerships that connect health services with universities and research institutes can support robust evaluation while keeping the patient experience central.

Long-term funding is equally important. Short grants may support a pilot, but maintaining staff training, digital systems, community engagement and evaluation requires a realistic financial model. Guidance on sustaining collaborative research can help partners plan beyond an initial funding cycle and protect the continuity needed for meaningful health improvement.

Priorities for health services and research partners

A practical programme can begin with a small number of clearly defined actions, then expand as evidence and capacity grow. The following priorities support a coordinated pathway:

• Make a documented vaccine recommendation part of routine antenatal appointments.
• Use local data to identify missed opportunities and inequities by setting and population.
• Offer vaccination at the point of care wherever clinically appropriate and feasible.
• Co-design information and outreach with communities, interpreters and consumer representatives.
• Evaluate coverage, timeliness, patient experience, workforce impact and safety together.

Research partners should share findings in formats that clinicians can use quickly, such as tested scripts, workflow maps, audit templates and implementation measures. Health services can contribute real-world questions, de-identified data and feedback from patients and staff, ensuring that research addresses practical priorities rather than remaining separate from care.

Improving vaccination during pregnancy is a continuing cycle of listening, testing, measuring and adapting. Queensland partnerships can connect discovery with delivery, helping effective approaches become consistent care for pregnant people, babies and families.

Health services, researchers and community organisations can begin by mapping their current antenatal vaccination pathway, identifying one preventable missed opportunity and testing a jointly designed improvement. Share the results through collaborative networks so successful practices can be strengthened and adapted across the region.