Measuring maternal Tdap and influenza vaccination rates: Comparison of two population-based methods

Koepke, Ruth; Schauer, Stephanie L.; Davis, Jeffrey P.

doi:10.1016/j.vaccine.2017.03.024

Cited by 14 publications

(17 citation statements)

References 5 publications

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“…In a random sample of 341 mothers who delivered at a large, quaternary care and referral academic health center in Florida during 2016-2018, a significantly smaller percentage of Medicaid-insured women received Tdap and influenza vaccines during pregnancy than did privately insured women. This finding is consistent with previous studies demonstrating lower vaccination rates among Medicaid-insured pregnant women (7,8). However, few studies have included information on receipt of Tdap and influenza vaccines during the postpartum period.…”

Section: Discussionsupporting

confidence: 92%

Variation in Tdap and Influenza Vaccination Coverage Among Pregnant Women by Insurance Type — Florida, 2016–2018

Merritt¹,

Rasmussen²,

Bright³

et al. 2020

MMWR Morb. Mortal. Wkly. Rep.

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Section: Discussionsupporting

confidence: 92%

Variation in Tdap and Influenza Vaccination Coverage Among Pregnant Women by Insurance Type — Florida, 2016–2018

Merritt¹,

Rasmussen²,

Bright³

et al. 2020

MMWR Morb. Mortal. Wkly. Rep.

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“…Two factors were statistically significant and potentially clinically meaningful in all analyses: likelihood of vaccination increased with receipt of the other vaccine during pregnancy (ORs=3.39À5. 19) and reduced with no pregnancy-related visits (ORs=0.23À0.40) (Appendix Table 2, available online). Other notable factors that increased the likelihood of vaccination included Hispanic origin and ≥11 versus 1−5 pregnancy-related visits, whereas age 15−19 years versus 30−34 years, black race, residence in rural areas, multiple gestation, and inpatient admission during baseline had the opposite effect.…”

Section: Resultsmentioning

confidence: 99%

“…Vaccination coverage discrepancies by insurance type have also been observed in other studies. 7,13,19,21,24 Tdap coverage varied from 20.8% in the South to 26.2% in the West. Similarly, Kriss et al 16 reported that Tdap coverage was lowest in the South and highest in the West.…”

Section: Discussionmentioning

confidence: 99%

Maternal Immunization in the U.S.: A Nationwide Retrospective Cohort Study

Ghaswalla

Poirrier

Packnett

et al. 2019

American Journal of Preventive Medicine

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Introduction: At present, pregnant women in the U.S. are recommended to receive tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) and influenza vaccines. This study assessed maternal coverage of these 2 vaccinations. Methods: Data for this retrospective cohort study were extracted from 2 large administrative claims databases, the MarketScan Commercial and Multi-State Medicaid Databases, for 2009−2017 and analyzed in 2018. Women aged 15−44 years on the date of pregnancy end were included. Pregnancies with gestational age of less than 23 weeks were excluded from the Tdap vaccination endpoint owing to the optimal recommended gestational age for Tdap vaccination. Multivariable logistic regression models identified predictors of vaccination. Results: The Tdap vaccination subpopulation included 1,421,452 Commercial and 523,635 Medicaid pregnancies; the influenza vaccination subpopulation included 1,862,705 Commercial and 628,079 Medicaid pregnancies. There were marked increases in vaccination coverage from 2010 to 2017: from 1.0% to 56.3% (Commercial) and from 0.5% to 31.4% (Medicaid) for Tdap, and from 14.7% to 31.3% (Commercial) and from 9.7% to 17.5% (Medicaid) for influenza. The likelihood of Tdap/influenza vaccination increased significantly with receipt of the other vaccine and more pregnancy-related healthcare visits. Conclusions: Although maternal Tdap and influenza vaccination coverage increased substantially from 2010 to 2017 among large, geographically diverse U.S. cohorts, coverage remained suboptimal, potentially putting newborns at risk of pertussis and influenza. Strategies to increase maternal vaccination coverage could target women identified to have a reduced likelihood of vaccination: those who are younger, black, residing in rural areas, with multiple gestation, and a prepregnancy inpatient admission.

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“…National guidelines recommend maternal pertussis vaccination between 28 and 32 weeks in each pregnancy. 6 Despite evidence supporting the effectiveness and safety of pertussis and influenza vaccination during pregnancy, uptake varies considerably with reported rates of 14-75% in the United States (US), [7][8][9] 30-60% in the United Kingdom (UK), 3,[10][11][12] and 26-70% in series from Australia. [13][14][15] Understanding the barriers and facilitators that contribute to such variability in uptake is central to implementing a successful and effective vaccination program.…”

Section: Introductionmentioning

confidence: 99%

Understanding the barriers to uptake of antenatal vaccination by women from culturally and linguistically diverse backgrounds: A cross-sectional study

Krishnaswamy

Cheng

Wallace

et al. 2018

Human Vaccines & Immunotherapeutics

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The role of maternal vaccination in reducing neonatal morbidity and mortality is expanding but uptake remains suboptimal. While the barriers to uptake have been well described, women from minority groups have not been well represented in previous studies. In this study we examine the facilitators and barriers to uptake of antenatal vaccination by women from culturally and linguistically diverse backgrounds in Melbourne, Australia. 537 women attending antenatal care completed a survey; 69% were born overseas. 63% had or intended to receive pertussis vaccine and 57% had or intended to receive influenza vaccine during their pregnancy. On multivariable analysis, predictors of uptake of pertussis vaccine were healthcare provider recommendation (OR 10, 95% CI 5-21, p < 0.001) and belief maternal pertussis vaccination is safe (OR 36, 95% CI 18-70, p < 0.001). For influenza vaccine, predictors of uptake were previous receipt of influenza vaccine (OR 8, 95% CI 5-15, p < 0.001) and healthcare provider recommendation (OR 30, 95% CI 16-56, p < 0.001). Lack of healthcare provider recommendation was the main reason for non-vaccination (17/46, 37%). While most women were aware of and intended to receive recommended vaccinations, recently arrived migrant women (resident in Australia for less than two years) were less likely to be aware of pertussis vaccine (15/22, 68% vs 452/513, 88%, p = 0.01) and less likely to believe it to be safe during pregnancy (4/22, 18% vs 299/514, 58%, p < 0.001). This highlights the important role of healthcare providers in recommending and educating women, particularly newly arrived migrant women, in their decisions about vaccination during pregnancy.

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Measuring maternal Tdap and influenza vaccination rates: Comparison of two population-based methods

Cited by 14 publications

References 5 publications

Variation in Tdap and Influenza Vaccination Coverage Among Pregnant Women by Insurance Type — Florida, 2016–2018

Variation in Tdap and Influenza Vaccination Coverage Among Pregnant Women by Insurance Type — Florida, 2016–2018

Maternal Immunization in the U.S.: A Nationwide Retrospective Cohort Study

Understanding the barriers to uptake of antenatal vaccination by women from culturally and linguistically diverse backgrounds: A cross-sectional study

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