Abstract
Pertussis and influenza infections can result in severe disease in infants. The diphtheria, tetanus, acellular pertussis (DTaP) vaccine is recommended for infants beginning at age 2 months, and influenza vaccine is recommended for infants aged ≥6 months. Vaccination of pregnant women induces the production of antibodies that are transferred across the placenta to the fetus and provide passive protection until infants are old enough to receive DTaP and influenza vaccines (1-3). To protect young infants before they are age-eligible for vaccination, the Advisory Committee on Immunization Practices (ACIP) has recommended since 2004 that all women who are or will be pregnant during influenza season receive inactivated influenza vaccine (1), and since 2013 that all pregnant women receive the tetanus, diphtheria, acellular pertussis (Tdap) vaccine (3). Tdap and influenza vaccination coverage was assessed among pregnant women in Minnesota. Vital records data containing maternal demographic characteristics, prenatal care data, and delivery payment methods were matched with vaccination data from the Minnesota Immunization Information Connection (MIIC) to assess vaccination coverage. MIIC stores vaccination records for Minnesota residents. Overall, coverage with Tdap vaccine was 58.2% and with influenza vaccine was 45.9%. Coverage was higher for each vaccine among women who received adequate prenatal care compared with those who received inadequate or intermediate care, based on the initiation of prenatal care and the number of recommended prenatal visits attended. Coverage also varied based on mother's race, country of birth or region, and other demographic characteristics. Further study is needed to better understand the maternal vaccination disparities found in this study and to inform future public health initiatives.
Highlights
The start date of the study was 1 week after publication of the current ACIP recommendation for Tdap vaccination during pregnancy. Because it takes time for health care providers to become familiar with and begin implementing new vaccine recommendations, it is likely that initial coverage rates were low because prenatal care providers were unaware of the new recommendation, or because their clinical practice guidelines had not yet been updated
Rates might have been lower at the beginning of the study period for these reasons, from 2013 to 2014, Tdap vaccination coverage during pregnancy increased 16.8%, suggesting that more prenatal care providers adopted the new recommendation as they became aware of it
Further investigation into reasons for lower vaccination coverage among certain racial and ethnic groups need to be explored to assist public health professionals and clinicians in addressing community-specific barriers to maternal vaccination
Summary
Coverage with Tetanus, Diphtheria, and Acellular Pertussis Vaccine and Influenza Vaccine Among Pregnant Women — Minnesota, March 2013–December 2014. Tdap and influenza vaccination coverage was assessed among women in Minnesota who had delivered a live birth during March 2, 2013–December 31, 2014. A list of Minnesota women who delivered a live birth during March 2, 2013–December 31, 2014 was compiled and pregnancy intervals were calculated This list was matched by mother’s name and birthdate to MIIC records. Among 127,073 live births in Minnesota with available and complete vital records for the period March 2, 2013– December 31, 2014, a total of 113,730 (89.5%) were matched to MIIC records Among these women, 66,222 (58.2%) had received at least one Tdap vaccine, and 52,248 (45.9%) had received at least one influenza vaccine during pregnancy (Table 1).
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