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VIP Study

Development work for an evaluation of a complex intervention to increase uptake of vaccinations in pregnancy among socio-economically and ethnically diverse populations

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About

Vaccinations against, flu, whooping cough, COVID-19 and respiratory syncytial virus can protect both pregnant women and their babies. Many pregnant women miss out on these vaccinations, especially women from disadvantaged backgrounds.

To find out why and to find possible solutions, we have reviewed the existing scientific research. In addition, we have conducted needs assessments in socially and ethnically mixed areas of London and  asked service users and providers for their recommendations. This has informed our planned VIP Study.

Our overall goal is to increase informed choice and uptake of vaccinations during pregnancy to prevent disease and death of mothers and babies and reduce health inequalities. As part of the VIP Study we will carry out development work together with pregnant or recently pregnant women, midwives and other stakeholders in London and Liverpool.

Get involved

Get in touch if the topic of maternal vaccinations interests you and is relevant to you – for example, if you are currently pregnant, were recently pregnant, know someone who is pregnant, or if you are a healthcare provider or other stakeholder.

Find out how to join our call for entries and win prizes.

Find out how to take part in our study by having a relaxed and friendly chat.

For more information or other ways to get involved, email: vip-study@lshtm.ac.uk

Funding

This project is funded by an NIHR Programme Development Grant (NIHR207562). Disclaimer: The views expressed above are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Who we are

The VIP Study team includes researchers from the London School of Hygiene and Tropical Medicine, St George’s University London, Kingston University London and University of Cambridge.

We also receive support from researchers, clinicians, nurses and midwives at the St George’s University Hospitals NHS Foundation Trust, Guy’s and St Thomas’ NHS Foundation Trust, Liverpool Women’s NHS Foundation Trust, and from the NIHR Clinical Research Network.

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About the study
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Lay summary

Background

Vaccinations against COVID-19, flu, whooping cough, and RSV can protect pregnant women/people and their babies from disease or death. But many pregnant women miss out on these vaccinations, especially women living in more deprived parts of the country and those from ethnically diverse communities.

To find out why vaccination rates are low and possible solutions, we reviewed existing research. We also carried out two studies in socially and ethnically mixed areas of London and asked pregnant women/people and health providers for their recommendations.

Our goal is to increase informed choice and uptake of vaccinations during pregnancy to improve health for underserved communities.

Planned work over 14 months

First, we will carry out research interviews with 10-15 midwives and ask their opinions. Then we will work with patients, the public and health providers (pregnant women, women hoping to become pregnant, midwives, maternity assistants and others) tol develop an improvement programme to increase vaccine uptake in pregnancy.

This will focus on service users, providers and services.

For service users

We will develop brief videos, where ‘real’ people, including midwives and pregnant women/people, their families, community stakeholders and community champions, share their personal stories about vaccinations in pregnancy.

For providers

We will develop materials and training for midwives and other HCPs to increase their knowledge, skills and confidence in maternal vaccines and their capability, opportunity and motivation to advise pregnant women/people about vaccinations against COVID-19, flu, respiratory syncytial virus (RSV) and whooping cough during pregnancy. To do this we will use evidence on how and why people change what they do to improve their health.

Services

We will explore possible service level factors, organisational and systemic changes to improve vaccination rates.

We will then carry out research interviews with 20 women and 20 midwives to obtain their feedback about our programme and adapt or amend it, if needed.

Patient and public involvement

Pregnant women/people recommended the work we have planned and helped design the research. We will work with them at every step, from designing the programme and research to sharing the results.

Expected impacts

Our study will result in a programme that can be delivered in the NHS and is acceptable to pregnant women, midwives and hospital staff. We will then apply for funding to do a large study across the UK to see if the programme increases vaccinations in pregnancy, including among people living in more deprived areas and those from a diverse ethnic population, and if it provides value for money. This could inform the way we provide services and improve the health of mothers and their babies. We will publish and share what we have learned with researchers, policymakers, healthcare providers and members of the public.ation 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.

Who we are

The VIP Study team includes researchers from the London School of Hygiene and Tropical Medicine, St George’s University London, Kingston University London and University of Cambridge. We also receive support from researchers, clinicians, nurses and midwives at the St George’s University Hospitals NHS Foundation Trust, Guy’s and St Thomas’ NHS Foundation Trust, Liverpool Women’s NHS Foundation Trust, and from the NIHR Clinical Research Network and Patient and Public Involvement (PPI) representatives.

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Asma Khalil

Co-Principal Investigator

Cari
Free

Clinical Professor (HCC) / Co-Principal Investigator

Pippa Oakeshott

Co-Investigator
Dr Sima Berendes

Sima
Berendes

Assistant Professor / Co-Investigator

Mohammad S Razai

Co-Investigator

Paul Heath

Co-Investigator
Prof Joe Tucker

Joe
Tucker

Professor of Global Health / Co-Investigator

Tushna Vandrevala

Co-Investigator

Chelone Lee-Wo

Co-Investigator

Emmanuela
Osei-Asemani

Research Assistant
Contest
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VIP open contest - deadline date will be announced soon! Watch out for our call for entries for the open contest below, which will be launched soon!

Do you want to help mothers protect themselves and the ones they love? 

We need your testimonies to increase vaccine uptake among pregnant women. Join our open call for entries/ and you could win a prize! 

Background

As part of the Vaccination In Pregnancy (VIP) study, we would like to create videos that feature real people sharing their experiences. We are looking for testimonies that can help more pregnant women from diverse backgrounds get vaccinated and protect themselves and their babies against infection.

Contest description and specific instructions           

Format of possible entries

  • Text (written stories or statements): maximum word count (tbc)
  • Photos or images (with description/ explanatory text): maximum file size (tbc)
  • Audio-clip: maximum file size (tbc)
  • Video-clips: No longer than 2 minutes (tbc), maximum file size: (tbc)  

If you submit a testimony, we may ask you later if you agree to being filmed by our professional video producer. We may also be able to help you even before your submission with recording or filming if needed. (See 'Tips and help for entries' and 'Frequently asked questions' below.)

Content of entries

Testimonies from people sharing their experiences to encourage uptake of vaccines in pregnancy. 

For example:  

  • Stories from women who have been vaccinated or healthcare workers who give vaccines during pregnancy. 
  • Real-life experiences from people who were initially not sure or did not take vaccines, but later changed their mind.  

You may talk about any type of vaccines that are recommended in pregnancy. These can include vaccines against whooping cough, flu, Covid-19 or respiratory syncytial virus (RSV). 

Who can enter/take part

You can take part if you are an adult (18 years or older and currently live or work in England. You can also submit an entry/contribution as part of a group of adults (including their children if applicable).

In addition, you need to be a current or former service user or service provider/ researcher, as explained below:

a) Service user: You can take part if you are currently pregnant, are planning to get pregnant or recently had a baby. You may also be able to take part if you are a relative or friend of a service user and the service user agrees to your taking part. Please see frequently asked questions below and get in touch if you are unsure if you are eligible).

b) Provider: Midwives, midwife assistants, doctors, pharmacists, healthcare managers, public health specialists, researchers, charity members and other people involved in antenatal care, postnatal care, and other services relevant to vaccination in pregnancy.

The same person can submit up to three different entries. 

Prizes (for each group, including service user and provider group)

We will distribute prizes worth up to a total of £3000. The prize distribution will be confirmed by the Contest Steering Committee, but may be as follows for each group:

  • One 1st Prize: £500
  • Two 2nd Prizes: £250 (each)
  • Three 3rd Prizes: £100 (each)
  • Four 4th Prizes: £50 (each) 
  • Timeline - Dates will soon be announced!
    • Launch of Open Contest: [tbc]
    • Submission deadline: [tbc]
    • Judging: [tbc]
    • Winner notifications: [tbc] 

Judging criteria

A panel of judges will mark your entry based on the following scoring criteria: 

  • Relevance to the project - How well your contribution fits with the goal of this contest. We are looking for testimonies that can help more pregnant women from diverse backgrounds get vaccinated.  
  • Authenticity - How ‘genuine’ and ‘sincere’ your contribution seems. (For example, less points will be given if a testimony looks as if it was written or played by an actor and not a ‘real’ pregnant woman or mother or by a ‘real’ midwife or other provider…). 
  • Impact - The persuasiveness of the testimony. 
  • Clarity and accuracy of content - Judges will rate whether your testimony is easy to understand and follow by a general audience. They will also consider whether what you say about vaccinations in pregnancy is accurate. 

Please note: We are happy to offer you support with improving clarity and accuracy, for example by helping you with your English. We may also be able to translate your text or add sub-titles with translations to a video, if you prefer to speak in a different language. If you are unsure if parts of your testimony are accurate, please feel free to contact us. Please see 'Tips and help for entries' section below. 

Each entry will be assigned scores between 1 to 10 (scale tbc by steering committee). Entries that achieve a mean score of ≥7 (tbc by steering committee) will be sent for a second round of judging with detailed feedback. Judges will include clinicians and experts in the field of maternal health as well as people with lived experience (tbc by steering committee).  

All participants who receive a mean score of 7/10 [tbc by steering committee] or greater, will receive a certificate of commendation. 

Among those who have a minimum mean score of 7/10 [tbc by steering committee] the prizes listed above will be distributed according to highest mean scores - up to 10 prizes for each submission group (service users and providers). 

Tips and help for entries/contributions

Information about vaccinations in pregnancy

Language support, technical help or accuracy checks

If you think you may need any support for your contribution, including with your language, with checking the accuracy of information or with technical issues, such as the creation or submission of audio-files or videos, please email vip-study@lshtm.ac.uk.

Rules of entry

  • You may submit up to three entries/contributions
  • Entries should be mainly your own work. The help of other people should be acknowledged.
  • Entries must be suitable for display to a general audience with respect to visual content and presentation. The use of vulgar words is not permitted.
  • You may withdraw your entry if you change your mind. (To do so, please get in touch - see contact info below) 

Submission link will be provided soon!

Frequently asked questions 

Can I apply as an individual or a group?

You can submit an entry either as an individual that features you (and your baby/child if applicable) or as a group. If submitting on behalf of a group, you would need to confirm that all group members have agreed to this submission. If applicable, up to 4 group members would receive a certificate, and any monetary prize would be shared among group members. 

Can a friend submit a contribution on my behalf, for example, if I have technical problems or if my English writing is not so good?

Yes, this is fine, but we will ask your friend to confirm that this is your contribution and you agree to this submission. 

Can I apply as a ‘service user’ if I had my baby abroad and not in England?

Yes, you can apply if you have had your baby abroad, as long as you currently live or work in England.  

Can I apply as a ‘service provider’ if I practiced abroad and not in England?

Yes, you can apply if you have mostly work experience abroad, as long as you currently live or work in England.  

How many entries/contributions can I submit?

You can submit up to three (tbc) entries/contributions. If you wish to make more than one submission, please submit each one individually. (Unless you wish to submit a photo/image in addition to a text file, which can be uploaded as part of a single submission.)  

What is my chance of winning a prize if my English is not so good, or if I am not good at writing or if I cannot film a video?

It does not matter how good your English is or whether your entry is a video. Your chance of winning prizes depends only on the scoring criteria. We would like to get testimonies from people with various backgrounds. Therefore, please let us know if you need help with anything before your submission. For example, if you wish to submit a video or audio-file, we may be able to help you with filming or recording. We may also be able to help you with translating your story.

For any questions or support, contact us via: vip-study@lshtm.ac.uk.

Can I change my mind about taking part?

Yes, if you change your mind after submitting your contribution/entry and wish to have your contribution/entry cancelled, please let us know via email vip-study@lshtm.ac.uk. (We may ask details about you or your contribution to ensure that the caller/ person who requests the cancellation is the same person who submitted the contribution.) 

What will happen to my entry if I win?

It will be used as part of the information about vaccination in pregnancy provided to pregnant women and midwives. We hope it will encourage more pregnant women, especially those from diverse backgrounds to be vaccinated against infection to protect themselves and their baby. 

Do you collect private information about participants?

No, we do not collect personal information such as names, IDs, etc.; the privacy of our participants is of paramount importance. To facilitate analysis of participation in the competition, we will collect some simple socio-demographic information (e.g. gender, age group, etc.) and basic contact details to enable us to keep in touch with participants. We will follow relevant data protection laws and ensure that your data are kept safe and no longer than necessary. 

Does it cost me anything to take part?

Taking part in the open contest is free of charge. Contest winners will receive the prizes described above. 

Contact information for further questions

If you have any questions or need help with anything, please get in touch via email vip-study@lshtm.ac.uk.

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There are several ways to get involved in the VIP Study, not only as part of the open contest, but also by sharing your thoughts during a relaxed and friendly interview with a researcher. These confidential study interviews may be held either in person, or via video or phone call. We will give participants a £20 gift voucher as a thank you for taking part.

As soon as the relevant Research Ethics Committees have reviewed and approved our study, we will in a first instance look for the following volunteers/participants:

a) Midwives and midwife assistants who are willing to tell us what they think about vaccinations in pregnancy, the relating services provided to pregnant women and possible ways to improve them in the future.

For more information and if you are interested in taking part, please see Participant Information Sheet and Informed Consent Form for healthcare providers and other stakeholders (available soon).

At a later stage of the VIP Study, we will look for the following volunteers/participants:

b) Pregnant women, who are willing to tell us what they think about the brief videos that we will develop from the personal stories/testimonies submitted during the open contest.

c) Midwives and midwife assistants who are willing to tell us what they think about the training and resources developed during the VIP Study.

For more information or other ways to get involved, email: vip-study@lshtm.ac.uk.

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A lay summary of the results of the VIP Study will become available here once the study has been completed.

The VIP Study is partly based on the results of the VIP-IDEAL study, a qualitative study published in a scientific journal in July 2023.

Access the scientific article published in the BMC Public Health journal (open access).

Please see a lay summary of the VIP-IDEAL study 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:

  1. A total of 38 pregnant or recently pregnant women
  2. 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.

Who funded and approved this study?

The VIP-IDEAL 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). Two of the authors (Sandra Mounier-Jack and Oyinkansola Ojo-aromokudu) were supported by the NIHR Health Protection Research Unit in Vaccines and Immunisation at  LSHTM in partnership with the UK Health Security Agency (UKHSA).

We 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.”

Where can I learn more about this study?

You can access the scientific article where we report the study findings in detail.

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.

Updates
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VIP Study funding confirmed and set-up phase commenced

Funding for the VIP Study by an NIHR Programme Development Grant has been confirmed and the study set-up phase has begun.

VIP-IDEAL Study results published in July 2023
VIP-IDEAL Study recruitment completed in September 2022