Women's Attitudes Toward Vaccination During Preconception Care [19A

Abstract

INTRODUCTION: Infection with Rubella or Varicella during pregnancy can have potentially lethal consequences to the fetus. Increasingly pervasive anti-vaccine beliefs make it even more critical for providers to assess adherence to MMR and Varicella vaccination, particularly in women attempting pregnancy. The primary outcome of this study was prevalence of non-immune status to Rubella and Varicella. Secondary measures were obtained from those with a negative immunity titer: self-reported attitudes, self-reported incidence of follow-up, recency of vaccine counseling and knowledge of CDC vaccination recommendations. METHODS: University of Kansas Health System Advanced Reproductive Care clinic patients from January 2017 through June 2019 with negative Rubella or Varicella titer results were invited to anonymously participate in an IRB approved survey. RESULTS: 1,767 patient records were reviewed. Non-immune status to Rubella and Varicella represented 7.2% (n=124) and 4.5% (n=79) of records, respectively. Surveys administered to all non-immune patients achieved a 32.5% (n=65) response rate. A minority of respondents did not receive the recommended vaccines following a negative titer, reportedly not wishing to further delay fertility treatment. Most respondents stated that they would be open to further vaccine education from their providers (67.7%). CONCLUSION: The prevalence of Rubella non-immunity in the study population fell within the recognized range for sufficient herd immunity (less than 13%). Our results indicate that women have a generally positive attitude toward vaccine education during pre-conception counseling. The risk/benefit analysis of postponing fertility treatment to achieve adequate levels of immunity should be a focused discussion with patients in the setting of advanced reproductive care.