Issue: December 2016
December 19, 2016
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OB/GYNs can improve vaccination among women

Issue: December 2016
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While most OB/GYNs administer vaccines, they primarily focus on influenza and tetanus-diphtheria-acellular pertussis vaccines for pregnant patients and HPV for nonpregnant patients; however, OB/GYNs can implement strategies to help increase adult vaccination uptake among other women, according to recent findings presented at IDWeek 2016.

Sean O’Leary

“For many women, OB/GYNs serve as their sole or primary source of care,” Sean O’Leary, MD, MPH, from the pediatric infectious diseases department at the University of Colorado School of Medicine and Children’s Hospital Colorado, in Aurora, said during his presentation. “So, if these women aren’t getting vaccinated in the OB/GYN office, they might not have access to vaccinations elsewhere. As such, OB/GYNs have the potential to play a critical role as vaccinators of women, but we know vaccination rates for influenza and [tetanus-diphtheria-acellular pertussis (Tdap)] in pregnancy remain relatively low and other adult vaccine uptake is also low.”

According to O’Leary, vaccination is a relatively new paradigm for OB/GYNs. Many did not start vaccinating women until the 2009 influenza pandemic, he said, and evidence suggests that some still do not vaccinate.

O’Leary and colleagues evaluated vaccination practices for pregnant and nonpregnant patients, and perceived barriers to immunization. They used an email and mail survey conducted from July 2015 to October 2015 among a national sample of OB/GYNs.

Among respondents who reported administering one or more vaccines in their practice, the most frequently administered to pregnant patients were influenza (85%) and Tdap (76%). For nonpregnant patients, the most frequent vaccinations included HPV (82%), influenza (70%) and Tdap (55%). Few participants reported administering any other vaccines to either group.

“The perceived barriers were primarily financial, and logistical and patient attitudinal barriers are also important,” O’Leary said. “But physician attitudinal barriers are essentially nonexistent. We know that if a woman doesn’t receive a recommendation or an offer for vaccination, she is far less likely to get vaccinated. The disconnect between the OB/GYN’s enthusiasm for vaccine delivery and their actual rates need further explanation.

“Evidence-based practices for increasing vaccination uptake have been primarily studied in pediatric, family medicine and internal medicine practices and they may not be as applicable and we may need to explore new evidence-based practices,” O’Leary concluded. “If OB/GYNs are to play a significant role as vaccinators of nonpregnant women, we really need a paradigm shift — very few are administering these vaccines.” – by Savannah Demko

Disclosure: The researchers report no relevant financial disclosures.