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Tdap Vaccination Coverage During Pregnancy - Selected Sites, United States, 2006-2015
Insights
Maternal Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccination rates increased significantly from 2009 to 2015. This rise in Tdap vaccine coverage during pregnancy aligns with recommendations to protect newborns from pertussis.
Area of Science:
- Obstetrics and Gynecology
- Pediatrics
- Epidemiology
Background:
- Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccination during pregnancy is recommended to protect newborns from pertussis.
- Infants are at high risk for pertussis-related morbidity and mortality.
Purpose of the Study:
- To analyze trends in Tdap vaccination coverage among pregnant women.
- To assess the proportion of women receiving Tdap vaccine in the recommended third trimester.
Main Methods:
- Utilized data from the Birth Defects Study, a case-control surveillance study of medications and birth defects.
- Analyzed vaccination data from 5,606 mothers of infants without structural birth defects (control group) from 2006 to 2015.
Main Results:
- Maternal Tdap vaccination coverage among control infants' mothers increased from <1% before 2009 to 54% by 2015.
- The proportion of women receiving Tdap in the third trimester increased to 94%-100% from 2010 to 2015.
- Most Tdap vaccinations (96%) occurred in traditional healthcare settings.
Conclusions:
- Maternal Tdap vaccination coverage has substantially increased.
- Increased vaccination coverage during pregnancy may reduce the burden of pertussis in infants.
Abstract:
Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine is recommended during the third trimester of each pregnancy to provide protection to newborns, who are at risk for pertussis-related morbidity and mortality (1). As part of its case-control surveillance study of medications and birth defects, the Birth Defects Study of the Slone Epidemiology Center at Boston University (the Birth Defects Study) has recorded data on vaccinations received during pregnancy since 2006. Among 5,606 mothers of infants without structural birth defects in this population (control group), <1% had received Tdap vaccine before 2009. By 2012, the percentage of mothers of infants in the control group (control infants) who had received Tdap increased to approximately 9%, and then in 2013 and continuing through 2015, increased markedly, to 28% and 54%, respectively. As the prevalence of maternal Tdap vaccination increased, so did the proportion of pregnant women who received Tdap in the third trimester, as recommended (94%-100% from 2010 to 2015). The vast majority of Tdap vaccinations (96%) were received in a traditional health care setting (e.g., the office of the woman's obstetrician or primary care physician or her prenatal clinic). Increasing vaccination coverage during pregnancy could help reduce the impact of pertussis on infant morbidity and mortality.
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