142nd APHA Annual Meeting and Exposition

Home Events & Meetings Annual Meeting Schedule & Program

Online Program

Annual Meeting Recordings are now available for purchase

307730
Tetanus, diphtheria, pertussis vaccination coverage during pregnancy: Evidence from the Pregnancy Risk Assessment and Monitoring System (PRAMS)

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014 : 3:30 PM - 3:50 PM

Indu Ahluwalia, MPH, PhD , Division of Reproductive Health, US Centers for Disease Control and Prevention, Atlanta, GA
Helen Ding, MD, MSPH , National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA
Denise D'Angelo, MPH , PRAMS Program, Centers for Disease Control and Prevention, Atlanta, GA
Kristen Helms, MPH , Division of Reproductive Health, CDC, Atlanta, GA
Jennifer Liang, MD , National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA
James Singleton, PhD, MPH , Ncird, CDC, Atlanta, GA
Background:In 2011, the Advisory Committee on Immunizations Practices (ACIP) recommended a dose of a tetanus, diphtheria and acellular pertussis (Tdap) vaccine during pregnancy for unvaccinated pregnant women and then in 2012, vaccination for both pregnant and  post-partum women.  In 2013, ACIP expanded the recommendation, advising pregnant women be vaccinated during each pregnancy.

Objective: To identify factors associated with Tdap vaccination coverage during pregnancy.

Methods: From September-December 2011, PRAMS collected data on Tdap vaccination from 20 states and New York City. Weighted analysis accounted for the complex survey design and non-response. Bivariate and multivariable logistic regression analyses were used to assess factors associated with Tdap vaccination during pregnancy.

Results:  Overall, 42.8% of 7,834 women received a Tdap vaccination (11.7% [n=987] before pregnancy, 6.6% [n=599] during pregnancy, 24.5% [n=2,009] after delivery); 38.1% (n=2,846) respondents did not report receiving vaccination and 19% (n=1,483) did not know their status.  Multivariable analyses of those who received vaccination during pregnancy versus not being vaccinated were higher among women who: were Hispanic versus white (adjusted odds ratio [AOR]=2.08; 95% confidence interval [CI]: 1.32-3.28), unmarried versus married (AOR=1.82; 95% CI:1.12-2.96),  received timely prenatal care (in the first trimester versus later) (AOR=1.94; 95% CI: 1.10-3.40); and reported  other sources of insurance versus private coverage (AOR=2.19; 95% CI 1.20-3.99). 

Conclusions: Most recent ACIP recommendations indicate Tdap vaccination for women during each pregnancy. Shortly after being recommended during pregnancy, Tdap vaccination coverage during pregnancy was low; public health efforts are needed to promote the new recommendations for Tdap vaccination during each pregnancy

Learning Areas:

Public health or related education
Public health or related research

Learning Objectives:
Explain the Tdap coverage among women with live-born infants Discuss the importance of Tdap vaccination of pregnant women during every pregnancy

Keyword(s): Immunizations, Maternal and Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Senior Scientist at CDC with a PhD in Epidemiology and an MPH. I am the lead epidemiologist with the Pregnancy Risk Assessment Monitoring system working on this topic and also serve on the CDC's Data Resource Center Advisory Committee thus am well-qualified to present on this topic.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3375.0: Data & Epidemiology: Surveillance & Data Mapping Strategies to Inform Health