Even after receiving an offer or referral from a health care provider, approximately a third of pregnant women remained unvaccinated.
A study by the CDC has found that only approximately half of pregnant women reported receiving the influenza and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccines. Even after receiving an offer or referral from a health care provider, approximately a third of pregnant women remained unvaccinated.
It has already been well-established that vaccinating pregnant women with the influenza and Tdap vaccines can reduce their own risk for contracting the diseases. Receiving the vaccinations, however, not only protects the mothers, but also protects the infants.
The researchers used data from the Influenza Hospitalization Surveillance Network and the Influenza-Associated Pediatric Mortality Surveillance System to quantify the proportion of influenza-associated hospitalizations among women aged 15-44 that occurred among pregnant women, the number of influenza-associated hospitalizations per 100,000, and influenza-associated mortality among infants less than 6 months old. They also utilized data from the National Notifiable Diseases Surveillance System to obtain pertussis case counts, hospitalization proportion, and mortality in infants less than 2 months old.
The study found that from the 2010-2011 flu season to the 2017-2018 season, pregnant women accounted for between 24-34% of influenza-associated hospitalizations per season among women age 15-44. This percentage is significant considering that only approximately 9% of US women aged 15-44 years are pregnant at any given time each year.
During the same time period, 3,928 pertussis-related hospitalizations were reported among infants less than 2 months old.
The study also confirmed earlier findings that vaccination coverage is lower among black pregnant women and those of lower socioeconomic status. While fewer than half (46.6%) of black women accepted influenza vaccinations when offered or referred, approximately two thirds (69.0%) of white women accepted the vaccine when offered or referred. Similar findings were found for the Tdap vaccinations: 53.3% among black women, 77.4% among white women, and 66.1% among Hispanic women. The authors noted that a separate study of the general population has found that black adults had lower levels of trust in the influenza vaccine, in their physician, and in information from the CDC.
Ensuring that pregnant women receive the proper vaccinations can go a long way toward reducing these numbers. As of April 2019, maternal influenza and Tdap vaccination rates were 53.7% and 54.9%, respectively. Among women whose health care providers offered vaccination or provided referrals, 65.7% received the influenza vaccine and 70.5% received the Tdap vaccine.
There were several reported reasons for non-vaccination. The most common reason was a belief that the vaccine is not effective, followed by being unaware that the vaccination is needed during each pregnancy. Some women also reported safety concerns for the infant as a reason for not receiving the vaccinations.
The study authors concluded that because health care providers are the most trusted source of vaccine information for pregnant women, conveying strong, specific recommendations can make a vital difference in the number of pregnant women receiving influenza and Tdap vaccinations.
Lindley M, Kahn K, Bardenheier B, D’Angelo D, et al. (2019).Vital Signs: Burden and Prevention of Influenza and Pertussis Among Pregnant Women and Infants—United States.[online] CDC. Accessed 9 Oct. 2019.