Maternal Vaccination Provision in NHS Maternity Trusts Across England

Background: Vaccinations for seasonal influenza and pertussis have been recommended for pregnant women in England since 2010 and 2012, respectively. Uptake rates are suboptimal with large regional variations. To improve uptake, from 2016 onwards maternity trusts were commissioned to offer pertussis (and other) vaccinations in addition to these being available in primary care. Since 2021, Covid-19 vaccinations have also been recommended for pregnant women. Overall maternal vaccination rates are routinely available, but not the relative provision by maternity trusts. We aimed to describe the national picture of maternity trust provision of maternal vaccinations.Methods: Cross-sectional survey.Results: Twelve NHS commissioners participated (from 13/06/22 to 31/03/23) providing data for 120 (of a total 124) maternity trusts across England. All 120 (100%) trusts were commissioned to deliver influenza, and 107 (89%) to deliver pertussis vaccinations, though not all actually administered the vaccines; 29% offered Covid-19 vaccinations. For 2021-22 we found a mean of 25% (range 0–81.3%) women were vaccinated for pertussis, and 11% (range 0–74.2%) for influenza, via their maternity trust, with large variations in rates between trusts (especially for pertussis) and no obvious match to the regional patterns seen for overall uptake (which includethose given in primary care). Commissioners reported a negative impact of the pandemic on routinevaccination provision. There was indication of efficiency by vaccinating women attending for otherappointments. There are diverse mechanisms for reporting pertussis and influenza vaccinations administered at maternity trusts back to primary care, which may be inefficient for maternity staff workload and data transfer.Conclusion: A high proportion of maternity trusts provide both pertussis and influenza vaccinations, despite a negative impact of the pandemic, with a marked increase since 2017-18. Reasons for the large variations should be explored to improve uptake and equity.