Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Influenza & Tdap Coverage Among Pregnant Women

MMWR; 2018 Sep 28; Kahn, Black, et al

Despite Advisory Committee on Immunization Practice (ACIP) recommendations, maternal vaccination with influenza and tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccines is suboptimal, and missed opportunities to vaccinate are common. This according to a recent Centers for Disease Control & Prevention (CDC) survey that examined influenza and Tdap vaccination coverage among pregnant women in the US and included 1,771 US respondents pregnant during the peak influenza season (October 2017 to January 2018). Researchers found:

  • During the 2017-18 influenza season, 49.1% of pregnant women received influenza vaccination before or during pregnancy.
  • 54.4% of women with a live birth received Tdap during pregnancy.
  • Only 32.8% received both recommended vaccines.
  • Vaccination coverage, regardless of vaccine type, was highest among pregnant women with a provider offer of vaccination.


Kahn KE, Black CL, Ding H, et al. Influenza and Tdap vaccination coverage among pregnant women—United States, April 2018. MMWR Morb Mortal Wkly Rep. 2018;67:1055–1059. doi:10.15585/mmwr.mm6738a3.


Current ACIP recommendations are that pregnant women receive both influenza vaccination and Tdap every pregnancy. This study shows that this is only successful about one-third of the time. Other studies have shown that the most effective way to increase this rate is through availability and strong recommendations from the clinician providing obstetrical care. It would also make sense to have the vaccines available in the obstetrical office and vaccine administration would be pared with a strong recommendation at the visit. —John Russell, MD