Clinical Edge

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Tdap Vaccination Disparities Among Pregnant Women

Matern Child Health J; ePub 2018 Oct 4; Kriss, et al

Among pregnant women in the US, disparities exist in tetanus, diphtheria, and pertussis (Tdap) vaccination, with health care provider (HCP) recommendation the most common factor influencing women to get vaccinated. Researchers conducted a nationwide cross-sectional web-based survey of pregnant women in the US during June-July 2014. The primary outcome was self-reported status with Tdap during pregnancy, categorized as vaccinated, unvaccinated with intent to be vaccinated during the current pregnancy, and unvaccinated with no intent to be vaccinated during the current pregnancy. Secondary outcomes included factors that influenced women’s decisions about vaccination and information needs. Among the findings:

  • 41% of women completing the survey reported that they had received Tdap during the current pregnancy.
  • Among women in the third trimester, 52% had received Tdap during the current pregnancy.
  • Hispanic women had higher Tdap vaccination compared with white and black women.
  • 26% of women had not yet been vaccinated with Tdap but intended to receive the vaccine during the current pregnancy.
  • The most common reasons for not getting vaccinated was concern about safety of the vaccine.
  • The most common factor that influenced women to get vaccinated was a HCP recommendation.


Kriss JL, Albert AP, Carter VM, et al. Disparities in Tdap vaccination and vaccine information needs among pregnant women in the United States. [Published online ahead of print October 4, 2018]. Matern Child Health J. doi:10.1007/s10995-018-2633-8.


This study is like many other studies of vaccines in pregnant women. As in many other studies we never seem to achieve our desired immunization rate in pregnant women. Like many other studies, the biggest concern of the expectant mothers is the safety of the vaccine for their child and the biggest impact on achieving a higher vaccination rate is the recommendation of a healthcare provider. We need to make sure that we are discussing vaccines with our pregnant population and we should take the time to listen to their concerns and be prepared to address any safety questions. —John Russell, MD