Department of Pediatric Surgery, McGovern Medical School at The University of Texas Health Science Center at Houston, 6410 Fannin St., Suite 471, Houston, TX, 77030, USA.
Department of Internal Medicine, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.
BMC Pregnancy Childbirth. 2022 Dec 28;22(1):975. doi: 10.1186/s12884-022-05296-5.
Vaccination of pregnant patients with tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) and influenza vaccine during influenza season can reduce maternal and fetal morbidity and mortality; nevertheless, vaccination rates remain suboptimal in this patient population. To investigate the effect of a brief educational counseling session on maternal Tdap and influenza vaccination and determine factors influencing women's decision in regards to receiving Tdap and or influenza vaccine during their pregnancy.
A face-to-face semi-structured cross-sectional survey was administered to postpartum patients on their anticipated day of discharge (June 11-August 21, 2018). A brief educational counseling session about maternal pertussis and Tdap vaccine was provided to interested patients after which the Tdap vaccine was offered to eligible patients who did not receive it during their pregnancy or upon hospital admission. Medical records were reviewed to determine if surveyed patients were vaccinated prior to discharge.
Two hundred postpartum patients were surveyed on their day of anticipated discharge. Of those who were surveyed, 103 (51.5%) had received Tdap and 80 (40.0%) had received influenza vaccinations prior to hospitalization. Among immunized patients, the common facilitators were doctor's recommendation (Tdap: 68, 54.4%; influenza: 3, 6.0%), to protect their baby (Tdap: 57, 45.6%; influenza: 17, 34.0%) and for self-protection (Tdap: 17, 13.6%; Influenza: 17, 34.0%). Of the 119 participants who had not received either Tdap or influenza vaccine prior to the survey, the barriers cited were that the vaccine was not offered by the provider (Tdap: 36, 52.2%; influenza: 29, 27.6%), belief that vaccination was unnecessary (Tdap: 5, 7.2%; influenza: 9, 8.5%), safety concerns for baby (Tdap: 4, 5.8%; influenza: 2, 1.9%). Of 97 patients who were not immunized with Tdap prior to admission but were eligible to receive vaccine, 24 (25%) were vaccinated prior to survey as part of routine hospital-based screening and vaccination program, 29 (38.2%) after our survey.
Interventions to educate pregnant patients about the benefits of vaccination for their baby, addressing patient safety concerns, and vaccine administration in obstetricians' offices may significantly improve maternal vaccination rates.
在流感季节为孕妇接种破伤风类毒素、白喉类毒素和无细胞百日咳（Tdap）以及流感疫苗可以降低母婴发病率和死亡率；然而，在这一患者群体中，疫苗接种率仍然不理想。本研究旨在调查简短的教育咨询对孕妇 Tdap 和流感疫苗接种的影响，并确定影响女性在怀孕期间接受 Tdap 和/或流感疫苗接种决定的因素。
在 2018 年 6 月 11 日至 8 月 21 日期间，对产后患者在预计出院日进行面对面半结构式横断面调查。对有兴趣的患者进行了关于母体百日咳和 Tdap 疫苗的简短教育咨询，之后向未在怀孕期间或入院时接种 Tdap 疫苗的合格患者提供 Tdap 疫苗。查阅病历以确定接受调查的患者在出院前是否接种了疫苗。
在预计出院日对 200 名产后患者进行了调查。在接受调查的患者中，有 103 人（51.5%）在住院前接种了 Tdap，80 人（40.0%）在住院前接种了流感疫苗。在已免疫的患者中，常见的促进因素是医生的建议（Tdap：68，54.4%；流感：3，6.0%）、保护婴儿（Tdap：57，45.6%；流感：17，34.0%）和自我保护（Tdap：17，13.6%；流感：17，34.0%）。在 119 名未在调查前接种 Tdap 或流感疫苗的参与者中，未接种疫苗的原因包括提供者未提供疫苗（Tdap：36，52.2%；流感：29，27.6%）、认为接种疫苗没有必要（Tdap：5，7.2%；流感：9，8.5%）、对婴儿安全的担忧（Tdap：4，5.8%；流感：2，1.9%）。在 97 名在入院前未接种 Tdap 但有资格接种疫苗的患者中，有 24 名（25%）在作为常规医院为基础的筛查和接种计划的一部分在调查前接种了疫苗，29 名（38.2%）在调查后接种了疫苗。
对孕妇进行疫苗接种对婴儿有益的教育干预、解决患者对安全的担忧，以及在妇产科医生办公室接种疫苗可能会显著提高孕妇的疫苗接种率。
