Exploring the Predictors for the Uptake of an Additional Maternal Vaccine Under the Immunization Programme in India

Introduction: Maternal immunization (MI) has evolved over the past decade, protecting both mother and offspring from infectious diseases. In India, only one vaccine, tetanus toxoid (TT)/ tetanus and diphtheria (Td), is available under the Universal Immunization Programme (UIP) for pregnant women. However, the basket of MI can be expanded by introducing the additional maternal vaccines in the immunization schedule. The study aims to explore the potential predictors for the uptake of additional maternal vaccines under UIP. Methodology: For the study, relevant data was extracted from the National Family Health Survey (NFHS-5) conducted during 2019-21. A cross-sectional sample of women aged 15-49 years who had given birth in the past 5 years was analyzed. Bivariate statistics and logistic regression analysis were employed to assess the predictors for pregnant women's interaction with healthcare workers (HCWs) during 3rd trimester of pregnancy using Stata 17 software. This measure was used as a proxy to gauge readiness for new vaccine introductions, like RSV, administered during the third trimester. Results: Information from 174,483 women was included in the study. Of them, 59.3% went for four or more antenatal care (ANC) visits, and a significant proportion (83.8%) received tetanus injections. The number of antenatal visits and tetanus injections during pregnancy emerged as strong predictors, with higher ANC visit frequencies with increased odds of meeting with healthcare workers (HCWs) during the third trimester of pregnancy. Further, younger age (20-24 years), middle wealth index group, and residence in rural areas were identified as positive predictors while higher levels of education emerged as a negative predictor. Conclusion: The study highlights the importance of ANC visits and tetanus vaccine uptake in engaging pregnant women with HCWs during the third trimester. These factors indicate readiness for potential interventions, like the RSV vaccine, and suggest leveraging ANC visits for introducing new maternal immunization vaccines.