Immunization Practices of U.S. Obstetrician/Gynecologists for Pregnant Patients

Abstract

Although most obstetrician/gynecologists administer some vaccines to pregnant women, the focus remains on influenza and Tdap. Financial barriers and infrequent use of evidence-based strategies for increasing vaccination uptake may be hindering delivery of a broader complement of adult vaccines in obstetrician/gynecologist offices.

Influenza and Tdap Vaccination Coverage Among Pregnant Women — United States, April 2018

“…** Another available resource is the ACOG immunization toolkit which includes communication strategies for providers. †† The toolkit also includes extensive information on vaccine financing and coding that could address perceived financial barriers, a commonly reported barrier to stocking vaccine ( 8 ).…”

Enhancing uptake of influenza maternal vaccine

“…There is evidence that a provider recommendation is strongly associated with vaccine receipt [14,15]. However, there is a significant discrepancy between the proportion of providers who say they recommend the vaccines and the proportion of women who accept the vaccine [17]. As described above, this discrepancy may be due to a lack of provider knowledge about the vaccine [15], provider perceptions of patient attitudinal barriers [17] or other logistical or financial barriers to provision of the vaccine in clinics [17].…”

“…Additionally, this discrepancy could be due to the method or content of the provider recommendation. It is unclear if prenatal care providers repeatedly recommend the vaccine or what the effect of the content or the strength of the recommendation is on women's decision to get vaccinated [17]. Given the importance of a provider recommendation for maternal immunization, there is a surprising dearth of studies intervening in the patient-provider relationship.…”

“…Multiple systematic reviews have identified that a provider recommendation is the single most important predictor of influenza vaccine uptake among pregnant women [14,15]. In addition to provider recommendation, other barriers include women's knowledge, attitudes and beliefs about the vaccine, particularly concerns about the safety of the vaccine for both mother and infant, provider knowledge about the recommendation, and logistical barriers such as offering the vaccine on site and vaccine reimbursement from insurance companies [14,15,16,17].…”

Maternal Vaccination as an Essential Component of Life-Course Immunization and Its Contribution to Preventive Neonatology

“…The extended role of Obstetrician-Gynaecologists as vaccinators and the developing systems approaches to facilitating vaccinations for women both during and outside of their pregnancies has been suggested [ 46 , 47 ]. However, financial barriers and the infrequent use of evidence-based strategies for increasing vaccination uptake may be hindering the delivery of a broader complement of adult vaccines in the offices of obstetricians/gynaecologists [ 48 ].…”