Association of Tdap vaccine guidelines with vaccine uptake during pregnancy.

<h4>Objective</h4>In 2012, recommendations for universal tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccination during pregnancy were released. Our objective was to determine if Tdap, influenza, and pneumococcal vaccine uptake during pregnancy changed after...

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Autores principales:	Julia D DiTosto, Rebecca E Weiss, Lynn M Yee, Nevert Badreldin
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2b36535c4c3549159ad903948df29753
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spelling	oai:doaj.org-article:2b36535c4c3549159ad903948df297532021-12-02T20:06:49ZAssociation of Tdap vaccine guidelines with vaccine uptake during pregnancy.1932-620310.1371/journal.pone.0254863https://doaj.org/article/2b36535c4c3549159ad903948df297532021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254863https://doaj.org/toc/1932-6203<h4>Objective</h4>In 2012, recommendations for universal tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccination during pregnancy were released. Our objective was to determine if Tdap, influenza, and pneumococcal vaccine uptake during pregnancy changed after the release of the guidelines, and identify factors associated with receiving the Tdap and influenza vaccine after 2012.<h4>Methods</h4>We conducted a retrospective cohort study on pregnant individuals who initiated prenatal care before 20 weeks' gestation between 11/2011-11/2012 ("pre-guideline") and 12/2012-12/2015 ("post-guideline"). Vaccine uptake dates were abstracted from medical records. The pre and post-guideline cohorts were compared to determine if Tdap vaccine uptake and timing improved after the new Tdap guidelines. We additionally examined influenza and pneumococcal vaccine uptake before and after guidelines. Factors associated with receipt of the Tdap and influenza vaccine during pregnancy in the post-guideline cohort were evaluated using multivariable logistic regression models.<h4>Results</h4>Of 2,294 eligible individuals, 1,610 (70.2%) received care in the post-guideline cohort. Among the pre-guideline cohort, 47.4% received Tdap, whereas Tdap uptake increased to 86.1% after the guidelines (p<0.001). Similarly, receiving the Tdap vaccine between the recommended time of 27-36 weeks gestational age improved from 52.5% to 91.8% after the guidelines (p<0.001). Vaccine frequency for influenza improved significantly from 61.2% to 72.0% (p<0.001), while frequency for pneumococcus were low and unchanged. An increased number of prenatal visits was associated with receiving the Tdap and influenza vaccines during pregnancy (respective, aOR 1.09 95% CI 1.05-1.13; aOR 1.50 95% CI 1.17-1.94). Non-Hispanic Black individuals were less likely to receive both the Tdap and influenza vaccines during pregnancy compared to non-Hispanic White individuals (respective, aOR 0.51 95% CI 0.33-0.80; aOR 0.68 95% CI 0.48-0.97).<h4>Conclusions</h4>Receipt and timing of Tdap vaccine improved after implementation of the 2012 ACIP guidelines. Receipt of influenza vaccine uptake also improved during the study period, while uptake of the pneumococcal vaccine remained low. Significant racial disparities exist in receipt of Tdap and influenza vaccine during pregnancy.Julia D DiTostoRebecca E WeissLynn M YeeNevert BadreldinPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0254863 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Julia D DiTosto Rebecca E Weiss Lynn M Yee Nevert Badreldin Association of Tdap vaccine guidelines with vaccine uptake during pregnancy.
description	<h4>Objective</h4>In 2012, recommendations for universal tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccination during pregnancy were released. Our objective was to determine if Tdap, influenza, and pneumococcal vaccine uptake during pregnancy changed after the release of the guidelines, and identify factors associated with receiving the Tdap and influenza vaccine after 2012.<h4>Methods</h4>We conducted a retrospective cohort study on pregnant individuals who initiated prenatal care before 20 weeks' gestation between 11/2011-11/2012 ("pre-guideline") and 12/2012-12/2015 ("post-guideline"). Vaccine uptake dates were abstracted from medical records. The pre and post-guideline cohorts were compared to determine if Tdap vaccine uptake and timing improved after the new Tdap guidelines. We additionally examined influenza and pneumococcal vaccine uptake before and after guidelines. Factors associated with receipt of the Tdap and influenza vaccine during pregnancy in the post-guideline cohort were evaluated using multivariable logistic regression models.<h4>Results</h4>Of 2,294 eligible individuals, 1,610 (70.2%) received care in the post-guideline cohort. Among the pre-guideline cohort, 47.4% received Tdap, whereas Tdap uptake increased to 86.1% after the guidelines (p<0.001). Similarly, receiving the Tdap vaccine between the recommended time of 27-36 weeks gestational age improved from 52.5% to 91.8% after the guidelines (p<0.001). Vaccine frequency for influenza improved significantly from 61.2% to 72.0% (p<0.001), while frequency for pneumococcus were low and unchanged. An increased number of prenatal visits was associated with receiving the Tdap and influenza vaccines during pregnancy (respective, aOR 1.09 95% CI 1.05-1.13; aOR 1.50 95% CI 1.17-1.94). Non-Hispanic Black individuals were less likely to receive both the Tdap and influenza vaccines during pregnancy compared to non-Hispanic White individuals (respective, aOR 0.51 95% CI 0.33-0.80; aOR 0.68 95% CI 0.48-0.97).<h4>Conclusions</h4>Receipt and timing of Tdap vaccine improved after implementation of the 2012 ACIP guidelines. Receipt of influenza vaccine uptake also improved during the study period, while uptake of the pneumococcal vaccine remained low. Significant racial disparities exist in receipt of Tdap and influenza vaccine during pregnancy.
format	article
author	Julia D DiTosto Rebecca E Weiss Lynn M Yee Nevert Badreldin
author_facet	Julia D DiTosto Rebecca E Weiss Lynn M Yee Nevert Badreldin
author_sort	Julia D DiTosto
title	Association of Tdap vaccine guidelines with vaccine uptake during pregnancy.
title_short	Association of Tdap vaccine guidelines with vaccine uptake during pregnancy.
title_full	Association of Tdap vaccine guidelines with vaccine uptake during pregnancy.
title_fullStr	Association of Tdap vaccine guidelines with vaccine uptake during pregnancy.
title_full_unstemmed	Association of Tdap vaccine guidelines with vaccine uptake during pregnancy.
title_sort	association of tdap vaccine guidelines with vaccine uptake during pregnancy.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/2b36535c4c3549159ad903948df29753
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Association of Tdap vaccine guidelines with vaccine uptake during pregnancy.

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