Tablet-Based Educational Application Increases Maternal Vaccination Uptake

Woman receiving vaccine pregnant.
During COVID-19, the pregnant woman receives a vaccine at the doctor’s office.
Researchers assessed the effects of practice-, provider-, and patient-level interventions on maternal vaccination uptake.

The use of a tablet-based educational application significantly increased the rate of maternal influenza and diphtheria-tetanus-pertussis (DTP) vaccination uptake, according to results of a cluster randomized trial published in Vaccine.

Researchers assessed the effects of practice-, provider- and patient-level interventions on the rate of maternal DTP and influenza vaccination uptake. For the practice-level intervention, an immunization champion — a staff member selected to encourage vaccination uptake — implemented of an Assessment, Feedback, Incentives, and Exchange (AFIX) program, an evidence-based continuous quality improvement program adapted to obstetric practices to increase vaccination uptake rates. The provider-level intervention involved educational programs used to educate clinicians on methods to increase maternal vaccination uptake. For the patient-level intervention, a tablet-based application was used to address specific concerns regarding vaccination via tailored educational videos. The primary outcomes were maternal influenza and DTP vaccination uptake rates through 34 weeks’ gestation.

A total of 2092 women were included in the analysis, of whom the majority were White (63%), highly educated (62.4%), and privately insured (71%). At baseline, 64% of women noted they intended to get vaccinated against influenza and 66% intended to get vaccinated against DTP.

Among women who did not intend to be vaccinated against influenza during pregnancy, the patient-level intervention was associated with a 35.5% increase in the rate of vaccination uptake compared with 22.0% among control patients (relative risk [RR], 1.61; 95% CI, 1.18-2.21). The patient-level intervention had no significant affect on vaccination uptake rates among women who did not intend to be vaccinated against DTP at baseline.

The researchers found that neither the practice- nor provider-level interventions were associated with a significant increase in maternal vaccination uptake rates.

This study was limited by its predominantly White, well-educated, and privately-insured patient population, thus the results may not be generalizable.

According to the researchers, “this trial highlights the importance of rigorous evaluation of interventions to increase uptake of maternal vaccines.”


Omer SB, O’Leary ST, Bednarczyk RA, et al. Multi-tiered intervention to increase maternal immunization coverage: a randomized, controlled trial. Vaccine. Published online July 8, 2022. doi:10.1016/j.vaccine.2022.06.055