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Vaccinations

Vaccinations

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Evaluation of Host-Pathogen Responses and Vaccine Efficacy in Mice

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Pertussis immunization in a high-risk postpartum population.

C Mary Healy¹, Marcia A Rench, Luis A Castagnini

¹Center for Vaccine Awareness and Research, Texas Children's Hospital, Houston, TX, United States. chealy@bcm.edu

|August 4, 2009

Summary

Postpartum tetanus, diphtheria, acellular pertussis (Tdap) immunization reached 72% of uninsured women in Houston using standing orders. Inaccurate immunization history and targeted education needs were identified barriers for improving Tdap vaccine uptake.

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Area of Science:

Public Health
Immunization
Maternal Health

Background:

Medically underserved and uninsured postpartum women are at risk for suboptimal immunization.
The Centers for Disease Control and Prevention (CDC) recommends tetanus, diphtheria, acellular pertussis (Tdap) vaccination for pregnant and postpartum individuals.
Implementing standing order protocols can improve vaccination rates in clinical settings.

Purpose of the Study:

To evaluate the effectiveness of a standing order protocol for postpartum Tdap immunization.
To assess Tdap vaccination uptake among medically underserved, uninsured postpartum women.
To identify barriers to postpartum Tdap immunization.

Main Methods:

A standing order protocol was used to provide CDC-recommended postpartum Tdap immunization.
The study population included medically underserved, uninsured women in Houston from January 7 to April 30, 2008.
Data on Tdap uptake, contraindications, and immunization history recall were collected.

Main Results:

72% (1129/1570) of postpartum women received Tdap before hospital discharge.
Tdap uptake was 96.2% in women without self-reported contraindications.
32% of unimmunized women inaccurately recalled antepartum immunization, and Black women had higher refusal rates (24% vs. 8%).

Conclusions:

Postpartum Tdap immunization was successfully implemented in a high-risk population via a standing order protocol.
Barriers to postpartum immunization include inaccurate immunization history recall.
Ongoing targeted education is necessary to further improve postpartum vaccination rates.