By Anna Halloran, Epidemiologist, Spokane Regional Health District

New data released from the CDC show not enough pregnant women are being vaccinated against influenza and pertussis during pregnancy. A survey of nearly 2,100 pregnant women ages 18 to 49 years, taken during the 2018-19 influenza season, found only 54 percent of pregnant women reported vaccination with influenza and only 55 percent reported vaccination with Tdap during pregnancy. Only 35 percent of women received both vaccines.

The ACIP and the American College of Obstetrics and Gynecology (ACOG) recommend pregnant women receive Tdap during each pregnancy between 27- and 36-weeks’ gestation for optimum passive antibody transfer to infants. The ACIP and the ACOG also recommend seasonal influenza vaccine to all women who are or will be pregnant during influenza season.

The Morbidity and Mortality Weekly (MMWR) report, Vital Signs: Burden and Prevention of Influenza and Pertussis Among Pregnant Women and Infants – United States, highlights many pregnant women do not receive the vaccines recommended to protect themselves and their infants, even when vaccination is offered. Among women whose healthcare providers offered vaccination or provided referrals, almost 66 percent received influenza vaccine and 70.5 percent received Tdap. Commonly reported reasons for not vaccinating included: believing the vaccine is not effective (influenza, 17.6 percent) and not knowing that vaccination is needed during each pregnancy (Tdap, 37.9 percent), followed by safety concerns for the infant (influenza, 15.9 percent; Tdap, 17.1 percent).

Locally, some offices providing obstetric care offer these vaccinations on site; however, most will instead refer women to outside entities, such as the woman’s primary care provider and pharmacies. Healthcare providers are encouraged to strongly recommend Tdap vaccination and offer vaccine on site. According to a 2017 CDC study, women are nearly two times more likely to be vaccinated during pregnancy if provided on-site vaccination  compared with women who received only a recommendation for vaccination but no offer of vaccination (70.4 percent vs. 36.9 percent). Less than 1 percent of pregnant women who reported not receiving a recommendation for Tdap vaccination were vaccinated.