Vaccination refusal among pregnant women: strategies that ob/gyns use

  • OʼLeary ST & al.
  • Obstet Gynecol
  • 4 Dec 2018

  • curated by Elisabeth Aron, MD, MPH, FACOG
  • Clinical Essentials
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Takeaway

  • Effective strategies for addressing vaccination refusal among pregnant women needed. 
  • Emphasizing risk to newborn may be effective.

Why this matters

  • Vaccination against influenza and pertussis (Tdap) is recommended for all pregnant women in each pregnancy.
  • Barriers to receiving vaccinations include: patient concerns about vaccination safety, fears of getting the disease, lack of time for provider to explain risks/benefits of vaccination.
  • Vaccination refusal among pregnant women is higher than refusal for childhood vaccines.

Key results

  • 69% response rate; most obstetrician/gynecologists (ob/gyns) reported favorable attitudes toward vaccinating their patients in concordance with current recommendations.
  • 90% reported administering at least 1 vaccine to their pregnant patients.
  • 60% used standing orders for influenza and 56% used standing orders for Tdap.
  • More pregnant women refused influenza vs Tdap.
  • Strategies used when patients refused vaccinations: stating vaccinations are safe in pregnancy (96%), not getting vaccinations puts newborns at risk (90%), not getting vaccinations puts patients at risk (84%), discussing outbreaks (72%), informing patient that not getting vaccination is against providers recommendations (64%), stating they would personally get vaccination or offer to family member (53%).

Study design

  • Internet and mail survey to ob/gyns in 2016.
  • Funding: CDC. 

Limitations

  • Only physicians surveyed.