Nurse-and Midwife-Led Strategies to Improve Maternal Immunization Uptake in Primary Healthcare and Community Settings: A Scoping Review
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Abstract
Maternal immunisation is a core public health strategy that boosts immunity in pregnant women and their babies. Despite the importance of vaccination in this demographic, uptake remains inconsistent and is influenced by individual, professional, and organisational factors. This scoping review aimed to map evidence on how nurses and midwives can address uptake barriers and support facilitators of maternal vaccination within primary care and community-based settings. It aligned with the Joanna Briggs Institute (JBI) methodology. It reported findings in accordance with the Preferred Reporting Items for Systematic Reviews and MetaAnalyses Extension for Scoping Reviews (PRISMA-ScR). We obtained relevant literature published between 2019 and August 2026 using PubMed/MEDLINE and citation searching.We supplemented this with database-specific searches in CINAHL and Scopus. Eligible studies were empirical peer-reviewed articles written in the English language published between January 2019 and August 2026. Sources for the scoping review had to be relevant, specifically addressing vaccination during pregnancy and including a nursing or midwifery contribution. After applying the eligibility criteria, the review deemed sixteen studies suitable for the evidence map. The evidence leaned more toward high-income settings and midwifery-led or midwifery-involved care. The review identified common barriers to maternal immunisation, including limited staff training, safety concerns and misinformation, time constraints, fragmented immunisation records, inconsistent recommendations, and difficulty accessing vaccines. The review reported promising vaccine uptake and feasibility for integrated antenatal vaccination and multi-component approaches.Although communication Training was associated with improved clinicians’ confidence; its association with vaccination uptake was inconsistent. Overall, the scoping review suggests that nurse- and midwife-involved maternal immunization interventions are operationally promising, although evidence on causality remains limited.
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