Rates of Adherence to Tdap Vaccination Guidelines in Pregnancy [10M]

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INTRODUCTION:In February 2013, the Advisory Committee on Immunization Practices released recommendations for vaccination of pregnant women with Tdap between 27 and 36 weeks gestation in every pregnancy. This is to protect neonates from pertussis between birth and eligibility for immunization. Maternal antibody levels wane quickly, so prior immunization is insufficient for passive immunization in subsequent pregnancies. We assessed compliance with current Tdap administration recommendations.METHODS:This is a retrospective chart review of obstetric patients in a faculty private office and a resident clinic between 10/1/13 and 9/30/14. 460 charts were reviewed. 237 had data sufficient for analysis. Differences in demographic characteristics and medical/obstetrical history were assessed using chi-square test and Fischer Exact test for categorical variables. Student's t test and Mann-Whitney U test were utilized to compare continuous variables.RESULTS:66% of women received Tdap during pregnancy, 91% of those during the recommended interval. In the clinic setting, 55% received the vaccine compared with 72% in the private office (P=.008). Approximately half the women who did not get Tdap during pregnancy received it postpartum in each setting. 11% of women declined when offered, (11.9% private office and 10.3% in the clinic). Factors associated with a higher likelihood of receiving the Tdap vaccine were having a low risk pregnancy, receiving the flu vaccine and care in the private office.CONCLUSION:There are opportunities for improvement in achieving the recommended of Tdap vaccination in each pregnancy. Few women decline so we need to ensure it is offered.

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