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Vaccination uptake for pertussis and influenza vaccines in pregnancy among different practices at a single
C Nieuwoudt1, C F Reeder2, H K Moss3
1Department of Obstetrics and Gynecology, Wake Forest, Winston-Salem, North Carolina, USA.
Insights
Pregnant individuals showed higher Tdap and influenza vaccine uptake in practices with standing orders and more advanced providers. Optimizing staff and protocols can improve antenatal vaccination rates.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Immunization Practices
Background:
- Advisory Committee on Immunization Practices (ACIP) recommends antenatal tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) and influenza vaccination.
- Evaluating vaccination uptake is crucial for maternal and infant health.
Purpose of the Study:
- To investigate Tdap and influenza vaccination rates during pregnancy.
- To identify practice-level factors associated with vaccination uptake.
Main Methods:
- Retrospective chart review of 17,973 women from January 2014 to December 2018.
- Examined vaccine receipt using Current Procedural Terminology codes.
- Analyzed data by practice type, staff composition, protocols, and insurance status using chi-squared tests.
Main Results:
- Highest uptake in university OBGYN faculty practices (Tdap 58.2%, influenza 56.5%).
- Lowest uptake in OBGYN resident practices (Tdap 28.6%, influenza 18.5%).
- Higher uptake associated with standing orders, advanced practice providers, lower provider-to-nursing ratios, and lower Medicaid rates.
Conclusions:
- Practice characteristics significantly influence antenatal vaccination rates.
- Standing orders, advanced practice providers, and optimized staffing ratios are linked to increased uptake.
- Future interventions should focus on optimizing practice staff and vaccination protocols to enhance vaccine coverage.
Objective:
The authors investigated tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) and influenza vaccination during pregnancy following Advisory Committee on Immunization Practices' (ACIP's) recommendation for antenatal pertussis vaccination.
Methods:
A retrospective chart review was performed in 2019 of women receiving prenatal care at our institution between January 1, 2014 and December 31, 2018. Receipt of ACIP-recommended vaccines were examined using Current Procedural Terminology codes to identify initiation of prenatal care, then administration of Tdap and influenza vaccines. Data were examined by individual practice (university faculty, community physicians, obstetrics and gynecology (OBGYN) residents, and family medicine residents, practice staff composition, vaccination protocol use, and insurance status. Statistical analyses were performed using χ2 testing and χ2 testing of linear trend.
Results:
Within our cohort (n = 17 973), highest vaccination uptake occurred in the university-based OBGYN faculty practice (Tdap = 58.2%, influenza = 56.5%) with lowest uptake in the OBGYN resident practice (Tdap = 28.6%, influenza = 18.5%). Higher uptake occurred in practices with standing orders, more advanced practice providers, lower provider to nursing ratios, and lower rates of Medicaid insurance.
Conclusion:
These data demonstrated higher vaccination uptake with standing orders, more advanced practice providers, and lower provider to nurse ratios. Future work optimizing practice staff composition and vaccination protocols may increase vaccine uptake.
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