Survey: Vaccination in Pregnant Women Increases with Access and Education from Providers

The CDC's Advisory Committee on Immunization Practices recommends that all women who are or may become pregnant during flu season receive an influenza vaccine, and all pregnant women receive a tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine.

The CDC analyzed survey data to assess influenza and Tdap vaccination among pregnant women during the 2017-2018 flu season and determined that health care providers can increase vaccination by offering vaccines or referring patients to someone who can provide them, and by educating patients on the safety, efficacy, and necessity of vaccines during pregnancy.

The survey concluded that women who were offered a vaccine by their provider were more likely to be immunized than those who were given a recommendation but not offered one, and those who were not given a recommendation by their provider. Women were also less likely to get a vaccine if they were concerned about the effectiveness of the vaccine or were unaware of the need for immunization during pregnancy, according to the CDC.

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Data concluded from the survey was weighted to reflect the age, race or ethnicity, and geographic location of all pregnant women in the United States. Of the thousands of women who participated in the survey, 1,771 met the survey criteria of being between the ages of 18 to 49 years and being pregnant at any time from August 1, 2017 through the dates of the survey, March 28 to April 10, 2018. As Tdap vaccination was recommended between 27 and 36 weeks of gestation, 700 women who reported being pregnant anytime since August 1, 2017, and giving birth to a live child were included in the survey. These 700 women were assessed to determine an estimate of the proportion of women who received both recommended vaccines, according to the CDC.

Women who responded were considered to be vaccinated for influenza if they received a vaccination before or during their pregnancy, with July 1, 2017 being the earliest date considered. Women who received Tdap during their most recent pregnancy were considered to be vaccinated for Tdap. Among the 1771 considered for the influenza survey, 49.1% received a vaccine before or during their pregnancy, and of the 700 considered for Tdap, 54.4% received a vaccine during their pregnancy. Of the 700 considered for both vaccinations, 32.8% received both recommended vaccines for expecting mothers, according to the survey.

Among women who were pregnant between October 2017 to January 2018, the peak flu vaccination period, 66% reported being offered a flu vaccine from their provider, 14.5% reported receiving a recommendation with no offer, and 19% reported no recommendation. Of the women who were offered a flu shot, 63.8% received one, while 37.6% of those whose providers recommended the vaccine received one, and only 9% of women who were not given a recommended reported being vaccinated.

Among women who gave birth from August 1^st through the survey dates, 67.4% were offered Tdap by their provider, 11.9% were given a recommendation with no offer, and 20.7% did not receive a recommendation. Among the women who were offered Tdap, 73.5% received the vaccine, compared to 38.3% of women who were given a recommendation, and 1.6% of women who did not receive a recommendation.

Women who were not vaccinated for influenza reported believing the flu vaccine was ineffective, and women who were not vaccinated for Tdap reported being unaware that women should receive the vaccine with each new pregnancy.

The CDC concluded that providers should make vaccines more accessible by offering them or referring patients to a provider who can vaccinate them, and to educate patients on the importance of these vaccines in protecting them and their baby.

Reference

Influenza and Tdap Vaccination Coverage Among Pregnant Women—United States, April 2018. CDC’s Morbidity and Mortality Weekly Report. CDC. September 28, 2018. https://www.cdc.gov/mmwr/volumes/67/wr/mm6738a3.htm?s_cid=mm6738a3_e. Accessed October 2, 2018.