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Assessment of Tdap administration rates from 2009 to 2012 at a large urban nonteaching hospital
Eric Wombwell1, Whitney Palecek, Elizabeth Englin
1Division of Pharmacy Practice and Administration, School of Pharmacy, University of Missouri-Kansas City, 2464 Charlotte Street, Kansas City, MO, 64108-2718, USA, wombwelle@umkc.edu.
Insights
Rising pertussis cases prompted an investigation into tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine administration. Tdap vaccine use significantly increased annually from 2009 to 2012, correlating with updated recommendations.
Area of Science:
- Immunization Practices
- Vaccinology
- Public Health Surveillance
Background:
- Pertussis (whooping cough) cases saw a significant rise in 2012.
- Advisory Committee on Immunization Practices (ACIP) guidelines for Tdap vaccination were updated during this period.
- Understanding vaccine prescribing patterns is crucial for public health.
Purpose of the Study:
- To investigate trends in tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine administration.
- To determine if changes in prescribing practices correlated with ACIP guideline updates.
- To analyze Tdap vaccine administration rates at a large urban hospital from 2009-2012.
Main Methods:
- Retrospective review of Tdap vaccine administrations from January 2009 to December 2012.
- Data extracted via electronic records at a single urban, private, non-teaching hospital.
- Incidence reported as Tdap events per 1,000 patient visits; compared with ACIP recommendations.
Main Results:
- Tdap administrations increased substantially from 1,365 in 2009 to 3,048 in 2012.
- Vaccine administration rates per 1,000 patient visits showed a statistically significant annual increase (23.96 to 47.15).
- No institutional initiatives were implemented to boost Tdap use during the study period.
Conclusions:
- Tdap vaccine administration demonstrated a clear and significant upward trend from 2009 to 2012.
- The study suggests a correlation between ACIP recommendations and provider prescribing of Tdap.
- While a definitive causal association cannot be established, the findings support the impact of guidelines on clinical practice.
Abstract:
Due to the significant rise in pertussis cases reported in 2012, these authors investigated the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine administration at our institution from 2009 to 2012 to determine if changes in prescribing practices reflected published updates from the Advisory Committee on Immunization Practices (ACIP). A single large, urban, private, non-teaching hospital. Documented Tdap vaccines administered from January 2009 through December 2012 were retrieved using an electronic data pull. The incidence of Tdap vaccine administration was reported as number of events per 1,000 patient visits. This data pull served to provide the longitudinal context to prescribing pattern changes at our facility, which were then compared to ACIP vaccination recommendation changes. Tdap administrations increased from 1,365 vaccinations in 2009 to 3,048 vaccinations in 2012. Tdap vaccine administration increased significantly each successive year from 2009 to 2012 from 23.96 ± 1.25 to 47.15 ± 1.63 vaccines per 1,000 patient visits to the facility. Confidence intervals did not overlap for consecutive years representing statistically significant differences between vaccination rates from year to year. Review of Tdap administrations demonstrates a clear and significant increase over consecutive years from 2009 to 2012. Over this time period there were no institutional initiatives aimed at increasing appropriate Tdap use at our institution. This study suggests a correlation between ACIP vaccination recommendations and provider prescribing of Tdap, although no definitive association can be made.
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