Pregnancy and Immunization: A Guide to Creating Patient Materials

"Development of accurate, clear, and understandable resources is important for increasing uptake of vaccines during pregnancy."

From American College of Obstetricians and Gynecologists (ACOG), this guide highlights evidence-based considerations and tips to support effective patient education messaging and materials to help women make informed decisions about immunisations during pregnancy. It is designed for organisations (e.g., vaccine advocacy groups or clinician/practitioner/patient organisations) and/or health entities (e.g., healthcare systems or health departments) developing vaccine education materials for pregnant women.

To develop the guide, ACOG, in collaboration with APCO Worldwide, conducted an online discussion group with 25 pregnant women on March 5 2020 to learn what types of messaging and graphics resonate best, and what information sources are the most trusted and easy to use. In addition, APCO carried out a literature review and audits of health literacy best practices and existing maternal immunisation patient education resources.

One finding that emerged from this research was that 7 in 10 expectant mothers in the discussion group have had a conversation with their healthcare practitioner about the importance of vaccines during pregnancy. However, respondents noted that clinicians sometimes do not make a strong recommendation during this exchange. Most characterised the interaction as a casual conversation followed by the distribution of an information sheet. This information highlights the need for sound educational resources for patients to supplement conversations with clinicians regarding maternal immunisation.

Table of contents:

• I. Introduction
• II. Maternal Immunization Messaging - e.g., it was found that a positive framing around maternal immunisation was more likely to motivate pregnant women to proactively research the topic or contact their healthcare practitioner for more information.
• III. Maternal Immunization Content Format & Material Distribution - covers use of visuals (infographics, photographs, and illustrations) and how to publish.
• IV. Resource Dissemination - covers print materials (handouts), video (animations, film), websites, and social media. ("Print is still king": Most of the pregnant women in the discussion group noted they appreciate that pamphlets can be reviewed at home and at their own pace.)
• V. Other Discussion Group Findings of Interest - e.g., healthcare practitioners should approach the topic of potential death carefully. Some pregnant women participating in the discussion group felt that talking about the risk of death from vaccine-preventable diseases was unfairly used as a scare tactic to intimidate women who are already nervous about their pregnancy.
  • Health Literacy Best Practices - includes guidance on text appearance, layout, and formatting, as well as these tips:
    1. Give the most important information first.
    2. Limit the number of messages.
    3. Tell your audience what they will gain from understanding and using the material.
    4. Keep in mind that the way your text looks greatly affects readability.
    5. Choose your words carefully (e.g., limit use of jargon).
• VI. Summary - offers a bullet-point recap (do's and dont's) of the practices outlined in this guide.
• VII. Conclusion
• VIII. Additional Resources and Appendices