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. 2018 Feb;54(2):205-213.
doi: 10.1016/j.amepre.2017.10.016. Epub 2017 Dec 13.

Immunization Practices of U.S. Obstetrician/Gynecologists for Pregnant Patients

Sean T O'Leary  1 , Laura E Riley  2 , Megan C Lindley  3 , Mandy A Allison  4 , Lori A Crane  5 , Laura P Hurley  6 , Brenda L Beaty  7 , Michaela Brtnikova  4 , Margaret Collins  7 , Alison P Albert  3 , Allison K Fisher  3 , Angela J Jiles  3 , Allison Kempe  4
Affiliations

Immunization Practices of U.S. Obstetrician/Gynecologists for Pregnant Patients

Sean T O'Leary et al. Am J Prev Med. 2018 Feb.

Abstract

Introduction: U.S. obstetrician/gynecologists play a critical role as vaccinators of pregnant women. However, little is known about their current immunization practices. Thus, study objectives were to determine (1) practices related to assessment of vaccination status and vaccine delivery for pregnant patients; (2) barriers to stocking and administering vaccines; and (3) factors associated with administering both influenza and tetanus, diphtheria, and acellular pertussis (Tdap) vaccines.

Methods: An e-mail and mail survey among a national sample of obstetrician/gynecologists conducted July-October 2015 (analysis August 2016-August 2017).

Results: The response rate was 73.2% (353/482). Among obstetrician/gynecologists caring for pregnant women (n=324), vaccination status was most commonly assessed for influenza (97%), Tdap (92%), and measles, mumps, and rubella vaccines (88%). Vaccines most commonly administered included influenza (85%) and Tdap (76%). Few respondents reported administering other vaccines to pregnant patients. More physicians reported using standing orders for influenza (66%) than Tdap (39%). Other evidence-based strategies for increasing vaccine uptake were less frequently used (electronic decision support, 42%; immunization information system to record [13%] or assess vaccination status [11%]; reminder/recall, 7%). Barriers most commonly reported were provider financial barriers, yet provider attitudinal barriers were rare. Providers who administered both influenza and Tdap vaccines were more likely to be female, perceive fewer financial and practice barriers, less likely to be in private practice, and perceive more patient barriers.

Conclusions: Although most obstetrician/gynecologists administer some vaccines to pregnant women, the focus remains on influenza and Tdap. Financial barriers and infrequent use of evidence-based strategies for increasing vaccination uptake may be hindering delivery of a broader complement of adult vaccines in obstetrician/gynecologist offices.

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Conflict of interest statement

CONFLICT OF INTEREST:

No authors have conflicts of interest to disclose.

Figures

Figure 1
Figure 1. Assessment of Vaccination Status and Vaccines Administered to Pregnant Patients by US Obstetrician-Gynecologists, 2015 (n=324)
Tdap, tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine; MMR, measles, mumps and rubella vaccine; HPV, human papillomavirus vaccine; Td=tetanus and diphtheria toxoid vaccine; assessment for pneumococcal vaccination status was generic and not specific to either vaccine.
Figure 2
Figure 2. Barriers to Stocking and Administering Vaccines among US Obstetrician-Gynecologists, 2015 (n=324)
Some percentages do not add up to 100% due to rounding
See this image and copyright information in PMC

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