Improving Maternal Vaccination: Analysis of Formative Interviews with Prenatal Health Care Providers.

OBJECTIVE: Maternal vaccination rates are low in the United States. Understanding barriers to vaccination for pregnant women from the provider's perspective can help better address these issues. This exploratory study assesses participating prenatal health care providers' beliefs and perspectives regarding maternal vaccination for Tdap, flu, COVID-19, and respiratory syncytial virus (RSV) vaccines. METHODS: This qualitative study included 24 virtual in-depth interviews with prenatal health care providers (12 physicians, 12 certified nurse midwives) working in rural and urban areas. Thematic analysis was conducted to identify perceived barriers and challenges to prenatal care, provider perceptions and recommendations on Tdap, flu, COVID-19, and RSV vaccines, vaccination resources shared with pregnant women, and vaccine administration practices. RESULTS: Most providers reported pregnant women were receptive to vaccination when benefits and risks of prenatal vaccination were explained. Rural providers identified barriers to care that included limited transportation, lack of access to health care, and language barriers. Findings also indicate prenatal health care providers can foster trust, engage in two-way conversations, and navigate patients' cultural influences when addressing vaccination challenges. CONCLUSION: Provider communication about maternal vaccination should be grounded in an evidence-based, participatory approach. Building trust, recognizing and addressing cultural barriers and access challenges are key to identifying practical steps to support access to and uptake of maternal vaccinations.