Clinical Edge

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

Influenza & Tdap Vaccination in Pregnancy

Vaccine; ePub 2018 Jun 12; Strassberg, et al

Tetanus, diphtheria, and acellular pertussis (Tdap) and influenza vaccination acceptance in pregnancy may improve when providers recommend the vaccination in combination with provision of educational materials on the vaccines, a new study found. From December 2014 to April 2015 women were given a questionnaire eliciting their experiences, attitudes, and history of influenza and Tdap vaccination in pregnancy during their routine prenatal care appointments. A similar questionnaire was administered to prenatal care providers. Researchers found:

  • 338 of 400 (84.5%) questionnaires were completed and returned; 24 of 45 (53.3%) provider questionnaires were returned.
  • Vaccination acceptance rates were 70.7% for the influenza vaccine and 76.3% for the Tdap vaccine.
  • Patients attitudes were more favorable towards Tdap than influenza vaccination.
  • Healthcare provider recommendation combined with educational materials was significantly predictive of both Tdap and influenza vaccine acceptance.
  • The most common reasons for declining the influenza vaccine were safety concerns; the most common reasons for declining Tdap vaccine were that patients did not think it was required again when they had received the vaccine before pregnancy.


Strassberg ER, Power M, Schulkin J, et al. Patient attitudes toward influenza and tetanus, diphtheria and acellular pertussis vaccination in pregnancy. [Published online ahead of print June 12, 2018]. Vaccine. doi:10.1016/j.vaccine.2018.05.121.


This prenatal study shows that most pregnant women are in favor of the recommended vaccines that they are to receive. Like many other vaccine studies, when patients are better educated about vaccines and their providers give stronger recommendations for vaccinations, they are more likely to take the vaccines. Even though the flu acceptance rate was only 70%, that is higher than the rate of receiving the flu vaccine among senior citizens in the US. With regards to the Tdap, it is not intuitively obvious that the mother needs to receive this vaccine with every pregnancy while other people in the home, fathers and siblings, do not need to receive it with every pregnancy. — John Russell, MD

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Must Reads in Vaccines

Parental Attitudes in Childhood Vaccine Exemptions, PLoS One; ePub 2018 Jun 14; Pottinger, Jacobs, et al

Measles in Vaccinated & Unvaccinated Patients, Clin Infect Dis; ePub 2018 Jun 7; Cherry, et al

Increases in HPV Vaccination in Young Males, J Infect Dis; 2018 Jun; Patel, Grabowski, et al

Influenza Vaccination Among Health Care Personnel, JAMA Network Open; 2018 Jun; Greene, et al

Prior Vaccination & Carriage Rates in Older Adults, Vaccine; 2018 Jul 5; Branche, Yang, et al