Provider group type and Tdap coverage in pregnancy

被引:2
|
作者
Cohen, Courtney C. [1 ,3 ]
Badger, Gary J. [2 ]
McLean, Kelley C. [1 ]
机构
[1] Univ Vermont, Dept Obstet Gynecol & Reprod Sci, Larner Coll Med, Burlington, VT 05401 USA
[2] Univ Vermont, Dept Med Biostat, Larner Coll Med, Burlington, VT 05401 USA
[3] Biltmore Ob GYN, 24 Med Pk Dr, Asheville, NC USA
关键词
Tdap immunization; Pregnancy; Provider characteristics; IMMUNIZATION INFORMATION-SYSTEMS; PERTUSSIS-VACCINE TDAP; ACELLULAR PERTUSSIS; INFLUENZA VACCINATION; UNITED-STATES; MATERNAL TDAP; TETANUS; DIPHTHERIA; WOMEN; BARRIERS;
D O I
10.1016/j.vaccine.2019.01.001
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Introduction: The Advisory Committee on Immunization Practices (ACIP) has focused on maternal Tdap immunization as an important means to protect neonates from pertussis infections. There is little published data on provider and/or clinic characteristics as predictors of maternal Tdap uptake. This study examined differences in maternal Tdap coverage in women delivering at a single academic institution, but cared for prenatally in different clinical settings, in 2013, 2014, and 2015. Additionally, the accuracy and utilization of Vermont's immunization information system (IIS) was assessed. Methods: This was a retrospective, multiple time-point cross-sectional analysis of annual maternal Tdap coverage in women delivering at a single academic institution in the 3 years following a fundamental change in national maternal Tdap vaccination guidelines. Tdap administration was examined across different obstetric groups using chart review and data from the state's IIS. Results: All obstetric care groups except the resident-staffed clinic significantly increased maternal Tdap coverage in 2014, compared to 2013 coverage, with no further increase in 2015. In contrast, there was no increase in maternal Tdap coverage in 2014 in the resident-staffed clinics, but then a statistically significant increase in 2015. Overall Tdap coverage in 2014 was 80.4%, with variation in Tdap coverage between clinics types. In the subset of women who were cared for by the University-based groups, there was significant variation in Tdap coverage between clinics, despite racial homogeneity, which persisted after adjustment for maternal age and insurance type. The state's IIS was found to be highly accurate, using individual chart review as the "gold standard." Discussion: While we demonstrated high maternal Tdap coverage in women delivering at our institution, differences in clinic type and provider training appeared to impact immunization rates, as well as how quickly evolving national recommendations were adopted. Additionally, the fidelity of the state's IIS data was verified. (C) 2019 Elsevier Ltd. All rights reserved.
引用
收藏
页码:1188 / 1193
页数:6
相关论文
共 50 条
  • [1] Childhood immunization coverage by provider type
    Groom, Holly
    Kolasa, Maureen
    Wooten, Karen
    Ching, Pamela
    Shefer, Abigail
    JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE, 2007, 13 (06): : 584 - 589
  • [2] Tdap vaccination in pregnancy
    Dalcin, Daniel
    Halperin, Scott A.
    CANADIAN MEDICAL ASSOCIATION JOURNAL, 2021, 193 (24) : E911 - E911
  • [3] Tdap During Pregnancy
    Paul, Yash
    INDIAN PEDIATRICS, 2014, 51 (03) : 237 - 237
  • [4] Tdap during pregnancy
    Yash Paul
    Vipin M. Vashishtha
    Indian Pediatrics, 2014, 51 (3) : 237 - 238
  • [5] Barriers for Tdap Vaccination in Pregnancy
    Ashby, Mary
    Roussos-Ross, Dikea
    DeCesare, Hanna Peterson Julie
    Vidrine, Samantha
    Floy, Elizabeth
    OBSTETRICS AND GYNECOLOGY, 2017, 129 : 40S - 40S
  • [6] Tdap Vaccination Coverage During Pregnancy - Selected Sites, United States, 2006-2015
    Kerr, Stephen
    Van Bennekom, Carla M.
    Liang, Jennifer L.
    Mitchell, Allen A.
    MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT, 2017, 66 (41): : 1105 - 1108
  • [7] Tdap vaccine during pregnancy
    MacDonald, Judy
    CANADIAN FAMILY PHYSICIAN, 2013, 59 (07) : 726 - 726
  • [8] Safety of TDaP Vaccination in Pregnancy
    Layton, J. Bradley
    Butler, Anne M.
    Li, Dongmei
    Boggess, Kim A.
    Becker-Dreps, Sylvia
    PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, 2016, 25 : 507 - 507
  • [9] Tdap- Vaccination in Pregnancy
    不详
    MONATSSCHRIFT KINDERHEILKUNDE, 2015, 163 (12) : 1228 - 1228
  • [10] Tdap in Pregnancy: A Quality Improvement Project
    Somer, Sarah J. Holdt
    Bruder, Karen
    Louis, Judette
    OBSTETRICS AND GYNECOLOGY, 2017, 129 : 30S - 31S