Predictors of Tdap vaccine acceptance in pregnancy before and after delivery.

Toubiyan, David; Fogel, Joshua; Jacobs, Allan J.

Background: Tdap vaccine receipt in the immediate postpartum period has not been well studied. Objectives: We study factors associated with Tdap vaccine receipt during both pregnancy and the immediate postpartum period. Design: Retrospective study of 2844 pregnant patients that delivered. Methods: Factors from demographics, medical history, previous obstetric history, prenatal care, and previous vaccination history were included. Results: 39.7% of patients received the Tdap vaccine, 39.5% received the Tdap vaccine prior to delivery, and 20.8% received the Tdap vaccine between delivery and discharge. Increased age (relative risk ratio (RRR): 0.98, 95% CI: 0.96, 0.99, p = 0.01) and lower number of prenatal care visits of fewer than 11 (RRR: 0.51, 95% CI: 0.41, 0.64, p < 0.001) were associated with decreased likelihood of vaccine receipt before delivery. Spanish language (before: RRR: 2.35, 95% CI: 1.69, 3.25, p < 0.001; after: RRR: 1.68, 95% CI: 1.13, 2.49, p = 0.01) and South Asian languages (before: RRR: 1.55, 95% CI: 1.03, 2.32, p = 0.04; after: RRR: 1.69, 95% CI: 1.06, 2.69, p = 0.03) had similar patterns for increased likelihood of Tdap vaccine receipt before and after delivery. Race/ethnicity of Hispanic (RRR:1.84, 95% CI: 1.31, 2.59, p = 0.001), Asian (RRR:1.65, 95% CI: 1.22, 2.22, p = 0.001), and receipt of influenza vaccine during current pregnancy (RRR: 1.58, 95% CI: 1.31, 1.91, p < 0.001) were associated with increased likelihood before delivery. Conclusion: Prenatal Tdap vaccination is the best way to prevent infection with B. pertussis. Postpartum Tdap vaccination provides some protection for those declining prenatal vaccination. We recommend that clinicians recognize that there are different patterns for Tdap vaccine receipt before and after delivery and tailor Tdap vaccine counseling based on these patterns. Plain Language Summary: Variables that can help understand whether and why pregnant women accept the Tdap vaccine before and after they deliver a baby We studied 2,844 consecutive people giving birth at our hospital to see who chose to receive the Tdap vaccine during pregnancy and shortly after delivery. We separately analyzed these two options for vaccination timing. About 40% received no vaccination, 40% were vaccinated before birth, and 20% vaccinated after giving birth but before leaving the hospital. Women who had the recommended 11 prenatal visits or more were more likely to receive vaccination than those with 10 visits or fewer; all patients had attended our prenatal clinic. Those with increased age were less likely to receive the Tdap vaccine before delivery. Those speaking Spanish or South Asian languages were more likely to receive the Tdap vaccine both before and after delivery. Race/ethnicity of Hispanic or Asian, and receipt of the influenza vaccine during the current pregnancy were more likely to receive the Tdap vaccine before delivery. Clinicians should be aware of the different patterns for Tdap vaccine receipt before and after delivery and can tailor their Tdap advice based upon these patterns.

NEW York (State); IMMUNIZATION; STATISTICAL significance; VACCINATION; PUERPERIUM; MMR vaccines; INFLUENZA vaccines; LOGISTIC regression analysis; RETROSPECTIVE studies; MULTIVARIATE analysis; RELATIVE medical risk; DESCRIPTIVE statistics; ATTITUDE (Psychology); DPT vaccines; PRENATAL care; PARITY (Obstetrics); VACCINE hesitancy; SOCIODEMOGRAPHIC factors; DATA analysis software; CONFIDENCE intervals; PREGNANCY

Therapeutic Advances in Vaccines & Immunotherapy, 2024, Vol 12, p1

2515-1355

Academic Journal

10.1177/25151355241287689