CHICAGO – Pregnant women were significantly more likely to receive information on pertussis vaccination from their pediatrician than from their obstetrician in a survey of 314 women.
"Multiple opportunities exist for education of obstetricians and gynecologists to improve Tdap vaccination rates in the United States," Dr. Rachel Gutkin said at the annual meeting of the Infectious Diseases Society for Obstetrics and Gynecology.
Dr. Rachel Gutkin
She reported on 314 pregnant women presenting to an academic perinatal center between March and June 2011 who answered an anonymous, multiple-choice questionnaire regarding their knowledge and opinions on vaccination in general, and Tdap (tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis adsorbed) specifically.
Overall, 218 (69%) of the women had heard about the Tdap booster vaccine, with 76 (24%) women learning about it at their pediatrician’s office and 54 (17%) at their obstetrician’s office.
Just 8% of women learned about Tdap from the Internet, while 19% did so from friends or family, and 17% from TV or radio, said Dr. Gutkin, a resident in the department of obstetrics and gynecology at the University of California, Los Angeles. The remaining 15% learned of it from other sources.
The majority of respondents knew that pertussis is a significant health risk for children (76%) and newborns (86%), and 50% also thought it was a significant health risk for fetuses.
When asked whether they would receive a Tdap vaccination during pregnancy to protect their newborn from whooping cough, 11% said they would if their doctor recommended it, 12% said yes if they knew it was safe, and 66% said they would if both conditions were true. Additionally, 11% said they would not receive Tdap during pregnancy under any circumstances, she said.
Women who discussed Tdap with their obstetrician were nearly five times more likely to be vaccinated than those who did not (odds ratio, 4.93). Only 13% of women who did not discuss Tdap with their ob.gyn. were vaccinated.
Although women were significantly more likely to discuss Tdap with their pediatrician, women were nearly three times more likely to be vaccinated if they were counseled by their ob.gyn. versus their pediatrician (OR, 2.9), Dr. Gutkin reported.
The survey was conducted in California, which in 2010 experienced the largest outbreak of pertussis in 65 years, with 9,120 cases reported, including 10 deaths. Cases peaked in some parts of California in the summer of 2010, but public health officials anticipate that numbers will remain high in 2011.
The respondents were well-educated, with 54% completing college and 32% graduate school. Most had PPO (Preferred Provider Organizations) insurance (91%), and the majority were aged 25-44 years (95%).
Still, almost one-quarter of women were not sure if vaccines in general are safe (22%). Roughly two-thirds were not sure if vaccines are safe in pregnancy (68%) and a full 10% were not sure if vaccines are effective in preventing illness, Dr. Gutkin said.
Women were significantly more likely to have discussed the influenza vaccine with their ob.gyn. than Tdap (47% vs. 19%), and to be vaccinated for influenza than pertussis (42% vs. 18%).
Of note, women were three times more likely to receive Tdap if they had received a flu shot (OR, 3.68).
"Discussion with their ob.gyn. was a significant factor in the acceptance of Tdap and influenza vaccines during pregnancy," she said.
Dr. Gutkin and her colleagues reported no relevant financial disclosures.