Provider group type and Tdap coverage in pregnancy.

Area of Science:

• Immunization Practices
• Maternal and Neonatal Health
• Public Health Policy

Background:

• The Advisory Committee on Immunization Practices (ACIP) recommends maternal Tdap immunization to protect neonates from pertussis.
• Limited data exists on provider and clinic characteristics influencing maternal Tdap uptake.
• This study addresses the gap in understanding factors affecting maternal Tdap vaccination rates.

Purpose of the Study:

• To examine differences in maternal Tdap coverage among women delivering at a single academic institution, based on prenatal clinical settings.
• To assess the accuracy and utilization of Vermont's immunization information system (IIS).
• To analyze the impact of evolving national guidelines on Tdap vaccination rates.

Main Methods:

• Retrospective, multi-time-point cross-sectional analysis of maternal Tdap coverage from 2013-2015.
• Data collected via chart review and the state's immunization information system (IIS).
• Comparison of Tdap administration across different obstetric care groups.

Main Results:

• Most obstetric care groups significantly increased maternal Tdap coverage in 2014, with varying adoption rates.
• Resident-staffed clinics showed a delayed increase in coverage, with a significant rise in 2015.
• Overall Tdap coverage in 2014 was 80.4%, with variations between clinic types; IIS data accuracy was verified.

Conclusions:

• Clinic type and provider factors appear to influence maternal Tdap immunization rates and adoption of national guidelines.
• High maternal Tdap coverage was achieved, but disparities exist.
• Vermont's IIS is a reliable data source for tracking immunization coverage.