The CDC recommends that all pregnant women receive the influenza vaccine and Tdap (tetanus, diphtheria, and acellular pertussis) vaccine during pregnancy to avoid influenza-related complications in the mother and pertussis in the infant. Clinicians can give influenza vaccine at any stage during pregnancy, but the Tdap vaccine is recommended during the third trimester of pregnancy or between weeks 27-36.1

Despite these recommendations, pregnant women have been under vaccinated. A recent study published in the Infectious Diseases: Research and Treatment journal surveyed pregnant women who gave live births to determine vaccination rates for both vaccines.2

This study found that less than a third of women were vaccinated with both influenza and Tdap. In their survey the researchers asked women for their reason to not have received both vaccinations. The most common responses included concern about vaccine effectiveness, perceived risk to baby, and concern about contracting influenza illness from the vaccine. They also said they either were unaware they needed a Tdap vaccine or had received it during a previous pregnancy. The researchers also found that the some respondents did not receive influenza vaccine because they believe it to be ineffective, even if they received the Tdap vaccine.

This information offers a great opportunity to improve practice by improving patient education.  Addressing patient concerns about vaccine safety and effectiveness is important to achieve higher vaccinations rates. Teaching patients the potential dangers of not receiving these vaccines is important as well.  Pregnancy makes a mother more prone to severe illness from the flu, and pertussis can be a deadly infection for newborns. Proactively educating on common misconceptions, such as not needing a Tdap vaccine, can also help to increase vaccination rates.

This study found that women were more likely to receive vaccines if their health care providers recommended them. Increasing education and recommendations is a crucial element of increasing maternal vaccination.

REFERENCES
  1. ACIP Guidance for Vaccine Recommendations for Pregnant Women. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/hcp/acip-recs/rec-vac-preg.html?CDC_AA_refVal=https://www.cdc.gov/vaccines/acip/committee/guidance/rec-vac-preg.html. Published April 15, 2016. Accessed May 7, 2020.
  2. Murthy NC, Black C, Kahn KE, et al. Tetanus, Diphtheria, and Acellular Pertussis and Influenza Vaccinations among Women With a Live Birth, Internet Panel Survey, 2017-2018. Infectious Diseases: Research and Treatment. 2020;13:117863372090409. doi:10.1177/1178633720904099.