Predicting postpartum mothers' intention for vaccinating their infants

Background Vaccines are administered for free in Israel. Yet, despite experts' agreement that vaccinations are important, some parents choose not to vaccinate their children - in part due to lack of trust in the health system. This study examines factors that predict mothers' intention to vaccinate their infants as per recommendations of the Israeli Ministry of Health. Methods The study included 344 women in a maternity ward of a hospital in northern Israel. After receiving approval from the Helsinki Commission, and with the mothers' consent, data were collected through a self-administrated questionnaire, from June to September 2019. Results Participants were aged 19-47 (M = 30.77), 96% were married, and 70% had 1-2 children. About 78% reported that their children had been vaccinated for hepatitis B upon birth and had received vitamin K by injection. About 20% did not know if their newborns had received the injection and vaccination, meaning that they probably did as part of the hospital routine. Only 1.5-3% of the mothers said they would vaccinate their child later or not at all. Overall, the mothers' intention to vaccinate their infants was high (4.33 on a 1-5 scale). A hierarchical linear regression model for predicting mothers' intentions to vaccinate their infants was significant, explaining 36% of the variance. Factors that predict mothers' intentions to vaccinate their infants as recommended include mothers' adherence to the pertussis vaccination administration during their pregnancy (P = 0.037), lower trust in non-medical factors (P < 0.001), and positive attitudes (P < 0.001), and subjective norms (P < 0.001) regarding vaccinating their infants. Conclusions Mothers' adherence to vaccinations during pregnancy could help identify at-risk populations. Interventions for encouraging vaccinations should focus on information sources and levels of trust, as trust in authoritative sources could assist in shaping attitudes and create a supportive environment for vaccinations. Key messages Mothers' adherence to vaccinations during pregnancy could help identify at-risk populations. Lower trust in non-medical factors, positive attitudes, and subjective norms are important predictors of mothers' intention for vaccinating their newborns.

It’s all about trust: Women's compliance with influenza and pertussis vaccinations during pregnancy

Background Although vaccination against pertussis and seasonal influenza during pregnancy is the safest and most efficient strategy to protect mothers and infants from related morbidity and mortality, maternal vaccination is unfortunately suboptimal. The aim of the current study is to assess vaccination compliance during pregnancy and the factors associated with adherence with the relevant Ministry of Health recommendations. Methods The study included 344 women in a maternity ward of a hospital in northern Israel. After receiving approval from the Helsinki Commission and with the mothers' consent, data was collected through a self-administrated questionnaire from June to September 2019. Results Eighty-three percent of participants reported having been vaccinated against pertussis during pregnancy, and 44% reported having been vaccinated against influenza. The main reasons for not being vaccinated were distrust in vaccine efficiency, fear of vaccination during pregnancy, and lack of recommendations from health professionals. Multivariate logistic regressions analysis showed that compliance with influenza and pertussis vaccinations were significantly explained by women's attitudes (influenza: OR 2.88; 99% CI: 2.05, 4.05; pertussis: OR 4.77; 99% CI: 3.04, 7.47) and norms (influenza: OR 1.55; 95% CI: 1.15, 2.08; pertussis: OR 2.09; 99% CI: 1.46, 2.99). Process procedure for mediation reveals that the greater the level of trust in the healthcare system, the more positive the attitudes and subjective norms toward vaccination during pregnancy, and the greater the likelihood of complying with both vaccination requirements during pregnancy. Conclusions Efforts should focus on raising women's trust in the healthcare system as an important part of shaping attitudes and creating a supportive environment for vaccination. Key messages Trust in the healthcare system is associated with positive attitudes and norms, which in turn contribute to vaccination compliance. Explicit recommendations for vaccinations among pregnant women made by health professionals are needed, including reassurance of vaccine safety and effectiveness.

Reduction of nutrient emission from Polish territory into the Baltic Sea (1988–2014) confronted with real environmental needs and international requirements

Eutrophication of the Baltic Sea is considered a major threat to its ecological status. We present and discuss Polish riverine flow normalized loads of total nitrogen (TN) and total phosphorus (TP) discharged into the Baltic Sea in (i)1988–2014, (ii) periods of maximum TN (1992–1994), TP (1988–1991) emission, (iii) the reference period (1997–2003) established by the Helsinki Commission (HELCOM), (iv) 2012–2014, last years of our study. Despite considerable nutrient load reductions prior to the HELCOM reference period, Poland is expected to reduce TN and TP loads by 30% and 66%, respectively. In the light of our historical and up-to-date findings defining ecological status of the Baltic Sea, we suggest that the proposed TP load reduction is overestimated and its realization may lead to (i) undesirable consequences for the Baltic ecosystem, (ii) would require a decline in TP concentrations to 0.067 mg P dm-3 (the Vistula River) and 0.083 mg P dm-3 (the Oder River), values reported for pre-industrial times. The current nutrient concentrations in the Vistula and Oder safely comply with the requirements of the Water Framework Directive. We also comment on the top-down and bottom-up effect resulting in quantitative and qualitative reorganization of the Baltic ecosystem, a phenomenon already observed in the Baltic Sea.

Indicators and scientific knowledge in regional Baltic Sea environmental policy

Backer, H. 2008. Indicators and scientific knowledge in regional Baltic Sea environmental policy. – ICES Journal of Marine Science, 65: 1398–1401. Since the 1990s, indicators have emerged as key tools used by the Helsinki Commission (HELCOM) for drafting regional Baltic Sea management actions and monitoring their implementation. The central role played by indicators in recent years can readily be seen in the 2007 Baltic Sea Action Plan (BSAP), where they have been used for defining quantitative targets and management actions and for providing background information. Similarly, the currently available, annually updated, web-based indicators include performance indicators with quantitative reference and target values, and descriptive indicators without such values. In addition to good indicators, implementation of the ecosystem approach, as is the aim of the BSAP as well as the newly adopted European Marine Strategy Framework Directive, requires extensive implementation of the precautionary principle and related concepts.

The HELCOM Copenhagen Declaration: A Regional Environmental Approach for Safer Shipping

Prevention of pollution from maritime traffic has been a major item for the Baltic Sea States since the beginning of their environmental co-operation in the 1970s. To ensure maritime safety in the Baltic Sea region, which is well-known for its narrow straits, shallow depths and archipelago areas, the Helsinki Commission has decided on a great number of measures during the past 20 years. In the last decade maritime transportation has been growing steadily, reflecting the intensified cooperation in the Baltic Sea region and a prospering economy which also leads to growing environmental risks. This was manifested again on 29 March 2001 with the Baltic Carrier accident. The Helsinki Commission promptly reacted by holding an extraordinary meeting on the request of the Danish Government on 10 September 2001 in Copenhagen. At the meeting, the Contracting Parties, represented through the ministers responsible for maritime transportation and the environment, and a representative from the EC agreed on a package of measures, further described below.