Survey of Obstetrics and Gynecology Residents Regarding Pneumococcal Vaccination in Pregnancy: Education, Knowledge, and Barriers to Vaccination.

Emily E Fay,Kara K Hoppe,Jay Schulkin,Linda O Eckert

doi:10.1155/2016/1752379

Abstract

Objective. The 23-valent pneumococcal vaccine is recommended for adults over 65 years of age and younger adults with certain medical conditions. The Centers for Disease Control and Prevention (CDC) state insufficient evidence to recommend routine pneumococcal vaccination during pregnancy, but the vaccine is indicated for pregnant women with certain medical conditions. We designed this project to gauge obstetrics and gynecology (OB/GYN) resident knowledge of maternal pneumococcal vaccination. Methods. We administered a 22-question survey to OB/GYN residents about maternal pneumococcal vaccination. We performed descriptive analysis for each question. Results. 238 OB/GYN residents responded. Overall, 69.3% of residents reported receiving vaccination education and 86.0% reported having ready access to vaccine guidelines and safety data. Most residents knew that asplenia (78.2%), pulmonary disease (77.3%), and HIV/AIDS (69.4%) are indications for vaccination but less knew that cardiovascular disease (45.0%), diabetes (35.8%), asthma (42.8%), nephrotic syndrome (19.7%), and renal failure (33.6%) are also indications for vaccination. Conclusion. OB/GYN residents are taught about vaccines and have ready access to vaccine guidelines and safety data. However, knowledge of indications for pneumococcal vaccination in pregnancy is lacking. Likely, the opportunity to vaccinate at-risk pregnant patients is being missed.

Highlights

Invasive disease from Streptococcus pneumoniae is a major cause of illness, including pneumonia, bacteremia, meningitis, and otitis media [1]
obstetrics and gynecology (OB/GYN) residents are taught about vaccines and have ready access to vaccine guidelines and safety data
Obstetrics and gynecology residency program directors and department chairs of Accreditation Council for Graduate Medical Education (ACGME) accredited OB/GYN residency programs in the United States were emailed in December 2013 and January 2014 and asked for their participation in the study

Summary

Introduction

Invasive disease from Streptococcus pneumoniae is a major cause of illness, including pneumonia, bacteremia, meningitis, and otitis media [1]. The Centers for Disease Control and Prevention (CDC) state insufficient evidence to recommend routine pneumococcal vaccination during pregnancy, but the PPSV23 is indicated for pregnant women with the medical conditions listed in the list below [3, 4]. Given the increasing incidence of obesity and related chronic conditions in the United States, there is likely a significant number of women who meet criteria to receive the pneumococcal vaccine during pregnancy [4]. For these women, the goal of maternal pneumococcal vaccination is both to prevent disease in the mother and to provide passive immunization to the neonates. Indications for pneumococcal vaccination in adults younger than 65 years old are as follows (adapted from the Centers for Disease Control and Prevention, pneumococcal disease; available at http://www.cdc.gov/pneumococcal/index.Html and retrieved on August 2, 2015)

Methods

Results

Discussion

Conclusion