Barriers to receipt of prenatal Tdap vaccine among mothers of young infants with pertussis

All pregnant women are recommended to receive Tdap vaccination to prevent potentially deadly infant pertussis, yet many neglect to be immunized.

All pregnant women are recommended to receive Tdap vaccination to prevent potentially deadly infant pertussis, yet many neglect to be immunized. In California—where takeup is at about 52% and even lower among Medicaid patients—114 cases of pertussis, including 2 fatalities, were documented in 2016 among infants younger than age 4 months. Researchers with the state Department of Public Health interviewed 66 mothers, along with their prenatal care providers, in an effort to pinpoint reasons for low Tdap vaccination rates. The results indicated that 30% of the women appropriately received the Tdap vaccine while pregnant—the vast majority of them during their prenatal clinic—but 40 of the 66 did not receive the vaccine. The data also showed that immunization was more likely when clinics were stocked with vaccine and also more likely among women with private insurance than those with Medicaid coverage, even when vaccine supplies were readily available. Moreover, roughly 40% of the unvaccinated mothers never received a recommendation or referral for Tdap vaccine or were deferred for reasons that were inconsistent with current recommendations. The authors of this review conclude that Tdap vaccination coverage among pregnant women is likely to increase through campaigns to educate providers about Tdap recommendations, promote onsite prenatal vaccination, strengthen off-site referrals, and incorporate Tdap vaccination into routine prenatal visits. Pharmacists in California, for example, are authorized to provide vaccinations.