The American College of Obstetricians and Gynecologists (ACOG) and its Committee on Gynecologic Practice, Committee of Obstetric Practice, and Immunization Expert Work Group have issued a committee opinion on “Integrating Immunizations Into Practice,” and the major role obstetrician-gynecologists can play in reducing morbidity and mortality from a range of vaccine-preventable diseases, including pertussis, influenza, human papillomavirus, and hepatitis. Recommendations include:
• Talk with each patient directly and strongly recommend indicated immunizations.
• If a patient declines an immunization, document the discussion and her decision. Inquire about her reasons for declining and reintroduce the discussion and offer the immunization at the next office visit.
• Designate an immunization coordinator in the office and identify a backup coordinator who is trained in case the designated coordinator is absent.
• Use prompts—paper or electronic—to remind physicians and staff which patients need to be immunized.
• If allowed by state law, institute standing orders for indicated immunizations. Standing orders allow immunization administration to appropriate patients without an individual physician order.
• After educating the patient, the obstetrician–gynecologist should document that the patient has been counseled regarding recommended immunizations, has been offered these immunizations, and that the patient accepted, declined, or obtained her immunization at an outside facility.
• Federal law (the National Childhood Vaccine Injury Act of 1986) mandates that all health care providers who administer vaccines must give patients or their parents or legal representatives the appropriate vaccine information statement (VIS), which can be used to educate patients, before administration of each dose of a vaccine.
Citation: O’Neal Eckert L, Beigi R, Tucker JM, et al. Integrating immunizations into practice. Committee Opinion No. 661. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2016;127:e104-7.
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