How can the illness risk representation framework be used to explain flu, whooping cough and Covid-19 vaccination uptake amongst pregnant women? A qualitative study.

To explore how the illness risk representation framework explains vaccination uptake in pregnant women. Pregnant women were recruited via hospitals and community groups. Semi-structured interviews with pregnant women, explored factors influencing vaccination uptake. Findings were analyzed using codebook approach to thematic analysis, and applied to illness risk representation framework (IRR). 43 interviews explored domains of the IRR showing good fit to vaccination beliefs of pregnant women. Identity beliefs focused on feelings of susceptibility to illness, beliefs about Cause related to exposure and prevalence to illness and feelings about immunity, Timeline beliefs included feelings about appropriate times to vaccinate, with some waiting to accept vaccinations. Beliefs about Consequences focused on perceived severity of illness and vaccine novelty, and Control beliefs included effectiveness of vaccinations, adverse effects and attempts to control exposure. Some domains of the IRR fit better than others, with estimates of likelihood and severity contributing to risk appraisals.