Training helps obstetric offices increase maternal flu vaccination
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Key takeaways:
- Researchers trained 12 obstetrics practices to discuss and recommend flu and Tdap vaccines to patients.
- Flu vaccination rates at participating offices increased but Tdap vaccination rates did not.
TORONTO — An online training module that instructed clinicians to assess vaccination status and use strong language to recommend vaccines helped increased influenza vaccine uptake at 12 obstetrics clinics, according to researchers.
Cynthia M. Rand, MD, MPH, a professor of pediatrics at the University of Rochester, and colleagues reported the results at the Pediatric Academic Societies Meeting.
“Nationally, vaccination rates for pregnant people are low for flu, particularly, and also for Tdap,” Rand told Healio. “I’m a general pediatrician, so I don’t take care of people when they’re pregnant, but I take care of the babies that they deliver. We can’t vaccinate infants until they’re 6 months old, so by protecting the mom, we can better protect them.”
Rand and colleagues recruited 27 obstetrics practices from four health systems in Los Angeles and Rochester with baseline vaccination rates of 57% and 56.7% for influenza and 72.7% and 78.7% for Tdap at any time in pregnancy, respectively, and assigned 12 practices to the intervention arm and 15 as control practices.
“Our intervention was to do training via online modules for the OBs and their nurses where we encourage them to assess vaccination status at every visit, at every prenatal visit with the pregnant person and to use a strong recommendation with declarative or presumptive language like saying, ‘You’re due for a flu vaccine,” instead of asking,” Rand said.
At the end of every month, the providers drew up an action plan regarding vaccine uptake to send to the researchers.
“We shared feedback with them every month, looking at the patients who delivered and at their vaccination rates for the patients who delivered that month,” Rand said.
Influenza vaccination rates increased by 8% (adjusted RR = 1.08; 95% CI, 1-1.15) in the intervention practices compared with control practices, but there was no increase in rates of Tdap given at 27 to 36 weeks (aRR = 0.94; 95% CI, 0.88-1) or Tdap vaccination rates overall (aRR = 0.94; 95% CI, 0.91-1.02).
Altogether, the authors found that the intervention raised flu vaccination by 12% in two systems, Tdap (27 to 36 weeks) vaccination rates by 10% in one system, and Tdap vaccination rates any time during pregnancy by 2% to 3% in two systems.
“The Tdap vaccination was not significant, and we think that’s because the Tdap rates were actually quite high to begin with in the practices that we worked with,” Rand said.
The researchers are examining sub analyses, and their future results will be “more defined by specific populations.”
“We want to encourage people to get vaccinated even before they get pregnant potentially, as soon as the vaccine is available, and we’d like to emphasize the benefit for the infant,” Rand said. “That really helps moms to understand how important it is for the potential future infant protection.”
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Rand CM, et al. Increasing influenza and Tdap vaccination rates for pregnant people: A cluster-randomized trial. Presented at: Pediatric Academic Societies Meeting; May 2-6, 2024; Toronto.
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