Objectives
Vaccination rates for adults are suboptimal. Recommendations from obstetrician/gynecologists (ob/gyns) increase vaccination uptake among women, particularly pregnant women. We examined: 1) current practices related to assessment of vaccination status and vaccine delivery for pregnant (PP) and non-pregnant (NPP) patients; and 2) perceived barriers to administering vaccines.
Results
The survey response rate was 73.2% (353/482). Respondents considered vaccines as a very or somewhat important component of overall care although there was a difference between PP (very, 88%, somewhat, 12%) and NPP (very, 36%, somewhat, 47%) (p<0.001). For PP, vaccination status was most commonly assessed for influenza (flu) (97% reported assessing), tetanus-diphtheria-acellular pertussis (Tdap) (92%), and measles-mumps-rubella (MMR) vaccines (88%). For NPP, the most commonly assessed vaccines were human papillomavirus (HPV) (92%), flu (82%), and Tdap (51%). Physician verbal communication (PP, 85%, NPP, 70%) and chart review (PP, 87%, NPP, 76%) were the most widely used methods to obtain vaccine history; only 11% of respondents used an immunization information system (IIS). Among practices administering at least one vaccine (90%), 85% give flu and 76% give Tdap to PP and 92% give HPV and 82% give flu to NPP. Commonly used strategies to increase vaccine uptake were standing orders for flu (PP, 66%, NPP, 51%) and Tdap (PP, 39%, NPP, 37%), and electronic (PP, 42%, NPP, 38%) or written (PP, 16%, NPP, 10%) decision support. The most commonly cited major barriers to stocking and administering vaccines included reimbursement for vaccine purchase (30%) and administration (25%), other preventive services taking precedence (22%), the burden of storing (19%) or ordering and tracking vaccines (18%), and patient factors such as refusal (18%), and insurance coverage (16%).
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