Journal of the National Institute of Public Health
Online ISSN : 2432-0722
Print ISSN : 1347-6459
ISSN-L : 1347-6459
Articles
Postpartum rubella vaccination rates and the related factors among Japanese women: A literature review
Miyu MitamuraMie Shiraishi Madoka YasuiMaki IwamotoMieko Shimada
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JOURNAL OPEN ACCESS

2017 Volume 66 Issue 1 Pages 47-55

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Abstract

Objectives: A decrease in rubella antibody retention ratio has been observed among Japanese women of reproductive age. In 2004, the Ministry of Health, Labour and Welfare in Japan recommended postpartum vaccination to women with low titers noted on hemagglutination inhibition (HI) test results (≤16) to prevent congenital rubella syndrome in their next pregnancy, as a strategy for elimination of rubella. However, the status of recommendations and rates of rubella vaccinations during the postpartum period remain unclear. Thus, the aim of this review was to confirm postpartum rubella vaccination rates and to identify the factors related to postpartum rubella vaccination in Japan.
Methods: A database search (Ichu-shi, CiNii, MEDLINE, PubMed, and CINAHL) was conducted for relevant publications after 2004 in English and Japanese. Two individual reviewers screened the results: with inclusion and exclusion criteria, as well as with a risk of bias assessment tool.
Results: Eight articles were included in this review. The rates of pregnant women with low titer (HI≤16) were 14.0%─46.6%. Postpartum rubella vaccination rates among women with low titer (HI≤16) were 18.1%─98.7% in six articles that recommended rubella vaccination in the postpartum period. However, the rates were 8.0%─10.2% in two articles that did not recommend vaccinations. Postpartum rubella vaccination rates of 4 articles that recommended vaccination during postpartum hospitalization were 20.7%─68.1%, and those of 2 articles that recommended vaccination at one month postpartum were 18.1%─56.3%. These integrated data analyses showed that vaccination recommendation by medical facilities and recommendation during postpartum hospitalization significantly led to higher rubella vaccination rate. In addition, one article reported that public subsidy for the cost of rubella vaccination was useful to increase postpartum vaccination rates. Additional related factors of postpartum rubella vaccination were as follows: desire for further pregnancies, judgment of patients as unsuitable for vaccination owing to physical problems, and lack of confirmation of women with low HI titer by healthcare professionals.
Conclusion: Recommendation of rubella vaccination and the timing, and public subsidy for the cost of rubella vaccination were identified as factors related to postpartum rubella vaccination. Proactive approaches such as recommendation of rubella vaccination by medical facilities, recommendation during postpartum hospitalization, and provision of information on public subsidy for rubella vaccination should be considered for increasing postpartum rubella vaccination rates.

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© 2017 National Institute of Public Health, Japan
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