Abstract
Vaccination of pregnant women with influenza vaccine and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) can decrease the risk for influenza and pertussis among pregnant women and their infants. The Advisory Committee on Immunization Practices (ACIP) recommends that all women who are or might be pregnant during the influenza season receive influenza vaccine, which can be administered at any time during pregnancy (1). ACIP also recommends that women receive Tdap during each pregnancy, preferably during the early part of gestational weeks 27-36 (2,3). Despite these recommendations, vaccination coverage among pregnant women has been found to be suboptimal with racial/ethnic disparities persisting (4-6). To assess influenza and Tdap vaccination coverage among women pregnant during the 2019-20 influenza season, CDC analyzed data from an Internet panel survey conducted during April 2020. Among 1,841 survey respondents who were pregnant anytime during October 2019-January 2020, 61.2% reported receiving influenza vaccine before or during their pregnancy, an increase of 7.5 percentage points compared with the rate during the 2018-19 season. Among 463 respondents who had a live birth by their survey date, 56.6% reported receiving Tdap during pregnancy, similar to the 2018-19 season (4). Vaccination coverage was highest among women who reported receiving a provider offer or referral for vaccination (influenza=75.2%; Tdap=72.7%). Compared with the 2018-19 season, increases in influenza vaccination coverage were observed during the 2019-20 season for non-Hispanic Black (Black) women (14.7 percentage points, to 52.7%), Hispanic women (9.9 percentage points, to 67.2%), and women of other non-Hispanic (other) races (7.9 percentage points, to 69.6%), and did not change for non-Hispanic White (White) women (60.6%). As in the 2018-19 season, Hispanic and Black women had the lowest Tdap vaccination coverage (35.8% and 38.8%, respectively), compared with White women (65.5%) and women of other races (54.0%); in addition, a decrease in Tdap vaccination coverage was observed among Hispanic women in 2019-20 compared with the previous season. Racial/ethnic disparities in influenza vaccination coverage decreased but persisted, even among women who received a provider offer or referral for vaccination. Consistent provider offers or referrals, in combination with conversations culturally and linguistically tailored for patients of all races/ethnicities, could increase vaccination coverage among pregnant women in all racial/ethnic groups and reduce disparities in coverage.
Highlights
Additional interventions to encourage consistent provider offers or referrals for influenza and Tdap vaccination and culturally competent conversations with patients are needed to address racial disparities in maternal vaccination
Influenza vaccination coverage among Black and Hispanic women increased, yet disparities persisted; Tdap vaccination increased among Black women but decreased in Hispanic women compared with 2018–19
Receipt of a provider offer or referral for Tdap was lower among Black (55.7%) than among Hispanic women (66.6%), women of other races (71.3%), and White women (81.0%). Among those with a provider offer or referral for Tdap vaccination, Tdap coverage was lowest for Hispanic women (52.5%), followed by Black women (64.7%), women of other races (73.1%), and White women (77.5%)
Summary
Influenza and Tdap Vaccination Coverage Among Pregnant Women — United States, April 2020. Among 1,841 survey respondents who were pregnant anytime during October 2019–January 2020, 61.2% reported receiving influenza vaccine before or during their pregnancy, an increase of 7.5 percentage points compared with the rate during the 2018–19 season. Among 1,841 pregnant women, 61.2% reported receiving 1 dose of influenza vaccine since July 1, 2019, an increase of 7.5 percentage points compared with 53.7% reported for the 2018–19 influenza season; Tdap coverage was 56.6% among women with a recent live birth, similar to that reported for 2018–19 (54.9%) (Table 1) (Figure). The proportion of women who reported receipt of a provider offer or referral for influenza vaccination was higher among Hispanic women (76.9%) than among White (69.5%) and Black (69.1%) women but was similar to that among women of other races (73.7%). The estimates reported here have variance, there has been no attempt to quantify the size of the variance
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