Tdap vaccine administered unequally among pregnant women
A pregnant woman’s race, primary spoken language and health insurance status played a role in determining her likelihood of receiving the Tdap vaccine, data show.
“Between 48% and 55% of pregnant women get the Tdap vaccine,” Amber Lalla, MS, a third-year medical student at the University of New Mexico, said during a virtual presentation at the American College of Obstetricians and Gynecologists annual meeting. “These rates are even lower amongst women of color, those who are uninsured and non-English speaking patients.”
The CDC, the American Academy of Family Physicians, the AAP and the American College of Obstetricians and Gynecologists all recommend that pregnant women receive the Tdap vaccine between their 27th and 36th week of pregnancy.
Lalla and colleagues compared Tdap vaccination rates among 372 pregnant women who attended at least two prenatal visits at either a Title V-funded clinic (n = 144), an OB-GYN clinic (n= 178) or a family medicine clinic (n = 50) within the University of New Mexico’s health system The Title V clinic had the most women who were not non-Hispanic white (96.5%), did not speak English (64.6%) and were uninsured (75.7%).
The researchers found that 31.9% of the women at the Title V clinic were administered the vaccine at any point in their pregnancy; 22.2% received it between 27th and 36th weeks of pregnancy; and 16% received it during labor and delivery. These rates were 71.9%, 61.2% and 84%, respectively, at the OB-GYN clinic, and 16%, 2.8% and 0%, respectively, at the family medicine clinic. According to Lalla, the ORs for non-Hispanic whites to receive the vaccine remained significant even after controlling the data for non-Hispanic whites who went to the Title V clinics.
“Based on these data, providing on-site Tdap vaccination, especially for uninsured pregnant patients, is ultimately a matter of health equity,” she said.
The findings led to a donation of the Tdap vaccine so that it can be offered to all pregnant women at Title V clinics within the University of New Mexico health system, Lalla said.