Despite provider support, vaccination in pregnancy remains low
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All providers supported administering vaccines that are safe in pregnancy to their pregnant patients, according to a poster presented at the Infectious Diseases Society for Obstetrics and Gynecology Annual Meeting.
Specifically, a related poster by the same research team demonstrated that most OB/GYN providers considered the COVID-19 vaccine to be safe in pregnancy.
However, the rate of vaccine uptake in this population — which was 61.2% for influenza in 2020, 56.6% for Tdap in 2020 and 18.9% for COVID-19 in 2021 — remained lower than the provider support rate.
“From our perspective, the data highlight a gap between strong recommendations from health care providers for vaccination in pregnancy and suboptimal rates of vaccine uptake in pregnant persons,” Eva Agasse, MPH, Gabriella F. Rodriguez, BS, and Valerie Vilariño, BA, told Healio in a joint statement. “The findings of this study garner potential opportunities to implement strategies to increase vaccine uptake.”
Provider perspectives on vaccination
Rodriguez and Vilariño, both MD candidates at the University of Miami in Florida, Agasse, a senior case worker at the University of Miami, and colleagues administered an anonymous survey between July and October 2021 to providers listed on national and local Miami, Florida, list-servs to assess providers’ attitudes toward and practices regarding vaccination in pregnancy.
In total, 100% of the 178 respondents — the greatest proportion of whom were white (77%), non-Hispanic (79%), women (82%), residents (48%), OB/GYN generalists (71%) and practiced in Florida (34%) — said that all pregnant patients should receive vaccines that are safe in pregnancy.
Additionally, 123 providers reported always counseling on the benefit of vaccination and 92 reported always documenting counseling in medical records.
When patients consented to vaccination, 127 providers reported administering the vaccine immediately, 10 reported administering it later and 20 referred patients somewhere else. In the case that patients refused vaccination, 137 providers determined why they did, 110 reported counseling again at a later visit and 12 asked other staff to counsel the patients. The researchers said they were surprised to find that nine providers did not re-counsel after refusal.
Fifty-one providers said they always documented why patients declined vaccination, and 81 providers said they sometimes did.
Provider attitudes on COVID-19 vaccination
The second poster, which focused on COVID-19 vaccination, detailed the attitudes and practices of 178 OB/GYN providers who responded to an anonymous survey between July and September 2021. According to the responses:
- 92.7% of providers considered the vaccine to be safe in pregnancy;
- 98.2% said they discussed COVID-19 vaccination in pregnancy; and
- 99.4% reported counseling their pregnant patients on COVID-19 vaccination.
To address the low rate of vaccine uptake, Agasse, Rodriguez and Vilariño suggested providers make a greater effort to re-counsel patients, determine the reason for refusal and provide onsite vaccination. Moving forward, they expressed interest in analyzing the costs and benefits of strategies to increase vaccine uptake.
“Furthermore, the results of this study spurred an interest in exploring providers’ attitudes and practices on other vaccines such as the HPV vaccine,” they said.
References:
- Rodriguez GF, et al. Abstract 50. Presented at: Infectious Diseases Society for Obstetrics and Gynecology Annual Meeting; Aug. 4-6, 2022; Boston.
- Vilariño V, et al. Abstract 56. Presented at: Infectious Diseases Society for Obstetrics and Gynecology Annual Meeting; Aug. 4-6, 2022; Boston.