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Group B streptococcus (GBS) is the commonest cause of sepsis and meningitis in the neonatal period in the UK with case numbers similar to that of meningococcal disease in older children.1 Mortality is around 10%, and 50% of GBS meningitis survivors are left with long-term neurodevelopmental sequelae.1
The selective use of intravenous antibiotics during labour has been shown to reduce the incidence of early-onset GBS infection in neonates, but has no effect on late-onset disease.2 Therefore, a better method of protecting infants is required.
An alternative could be antenatal vaccination against GBS and a potential vaccine candidate is currently being trialled in pregnant women.3 However, uptake of other antenatal vaccines is variable and some women may have concerns about potential adverse effects on their developing baby. Nevertheless, the recent UK pertussis outbreak, which resulted in 14 deaths in babies too young to be immunised themselves, led to the introduction of a vaccination programme for pregnant women. Vaccine uptake of almost 60% has been achieved suggesting that antenatal immunisation can be acceptable.4
To assess the attitudes of women of child-bearing age in Great Britain towards antenatal immunisation and GBS, an email link to an online survey was sent to 1221 women aged 18–44 years in England, Scotland and Wales by a market research company (ComRes, London, 13–17 September 2013). The survey was adequately completed by 1013 women (83%). The questions are shown in table 1 and figure 1. After completing the first part of the survey, respondents were then shown information about GBS disease and asked to respond again to the questions regarding vaccination against GBS. Respondents were asked to rate how important they considered advice about immunisation from a list of sources. The survey was funded by Meningitis Now.
As expected, knowledge about GBS was limited compared to pertussis and influenza, both of which have been more prominent in the media recently. However, this did not seem to affect women's willingness to receive a vaccine against GBS with similar percentages reporting they would likely be willing to receive a vaccine for all three conditions surveyed. Providing information about GBS increased the percentage of those likely to accept vaccination from 72% to 82%. Of particular interest to those planning further studies of antenatal GBS vaccines, a third of respondents (32%) reported they would consider taking part in clinical trials if the vaccine had previously been tested in 500 women (roughly the number enrolled in clinical trials to date3). The role of health professionals in providing immunisation advice was emphasised by 87% of respondents stating they would consider advice from their general practitioner to be important compared with 74% from their partner.
These findings are encouraging in terms of the acceptability of antenatal immunisation in women of child-bearing age, and their reported willingness to take part in research suggests that future GBS vaccine studies would be feasible in the UK. More information is required about the specific barriers and motivations to receiving vaccination during pregnancy in order to optimise vaccine uptake rates.
We would like to thank the participants in the online survey and E. Di Antonio (ComRes) for assistance with survey preparation.
Contributors FM and MDS prepared the first draft of the text of this article and revised it in response to comments from all coauthors. FM prepared the table and figure. The online survey was designed by all authors.
Funding This survey was funded by a grant from Meningitis Now (formerly Meningitis UK).
Competing interests PTH serves as a consultant to Novartis Vaccines regarding GBS vaccine development. He receives no personal funding for this. The remaining authors have no potential conflicts of interest to declare.
Provenance and peer review Not commissioned; internally peer reviewed.
Data sharing statement Additional unpublished data are available to members of the public from the ComRes website: http://www.comres.co.uk/poll/1028/gbs-vaccination-survey.htm.
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