Maternal Self-Report of Tetanus Diphtheria Pertussis Vaccination during Pregnancy Correlates with Patient-Specific Electronic Medical Records

Song, Ailin; Sherin, Margaret; Cleary, Shannon; Spino, Catherine; Bernstein, Henry H.

doi:10.1016/j.jpeds.2021.03.015

Cited by 5 publications

(4 citation statements)

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“…Lastly, the survey relies on the self-report of participant interactions with their OB/GYN, but not from the obstetric providers’ recall or as documented in the medical record. Previous studies have shown that while self-report on vaccine uptake is reliable, it is not perfect, so it is reasonable to conclude that some participants may not fully remember this interaction with their OB/GYN as it occurred (Song et al, 2021 ; LeardMann et al, 2007 ).…”

Section: Discussionmentioning

confidence: 99%

“…In addition, our survey was adapted from the Health Belief Model; while elements of the Health Belief Model had been used to ask about antepartum vaccinations previously (Becker, 1974 ; Dempsey et al, 2016 ; O’Leary et al, 2015 ), the novelty of this study is further enhanced as it is one of the first to apply the Health Belief Model specifically to Tdap. The analysis uses vaccination status from the medical record, which some consider more accurate than patient self-report, although a high level of concordance between the electronic medical record and self-report has recently been shown (Song et al, 2021 ). Our mixed methods approach of utilizing survey responses to complement vaccination data collected from the EMR offered a unique opportunity to develop a comprehensive picture of the antepartum Tdap landscape.…”

Section: Discussionmentioning

confidence: 99%

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Factors Influencing Maternal Antepartum Tdap Vaccination

Bernstein

Tong-Miller

Cleary

et al. 2022

Matern Child Health J

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Introduction Antepartum Tdap remains low despite national recommendations. This prospective observational study aims to identify factors associated with lower antepartum Tdap rates. Methods Maternal demographics, personal health beliefs, Tdap vaccination status, and recall of in-office obstetric provider actions were collected from a convenience sample of postpartum women in a New York metropolitan hospital. Bivariate and multivariable logistic regression were used to identify significant factors and adjusted odds ratios (OR) for recorded Tdap; OR > 1 reflects elements with increased odds of not receiving antepartum Tdap, while OR < 1 demonstrates increased odds of receipt. Results Surveys were collected (n = 1682) from a study population demographically similar to New York City and more diverse in race/ethnicity than the national population. Demographic analysis showed Hispanic women less likely than white, non-Hispanic women to vaccinate (OR 2.44, CI 1.54–3.88). Health beliefs associated with non-receipt of antepartum Tdap included “It is dangerous for pregnant women to get vaccines” (OR 1.68, CI 1.01–2.77), and “I worry about the safety of the Tdap vaccine” (OR 1.59, CI 1.12–2.24). Obstetric provider actions associated with vaccination included receiving an OB recommendation (OR 0.39, CI 0.23–0.65), getting written information about Tdap (OR 0.44, CI 0.30–0.64), and having Tdap offered in office (OR 0.24, CI 0.15–0.37). Health beliefs associated with antepartum Tdap included “I generally do what my OB/GYN provider recommends” (OR 0.49, CI 0.30–0.80), and “Pregnant women should get the Tdap (pertussis) vaccine” (OR 0.17, CI 0.09–0.33). Discussion Maternal race/ethnicity, personal health beliefs, and obstetric provider actions predict antepartum Tdap.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Factors Influencing Maternal Antepartum Tdap Vaccination

Bernstein

Tong-Miller

Cleary

et al. 2022

Matern Child Health J

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“…When screened for diphtheria, IgG levels remained high in all age groups, with only slight fluctuations. However, in recent years, authors, both in Russia and other countries, have noted a gradual loss of antidiphtheria immunity with age ( 17 , 24 – 27 ). In many countries, an increase in the proportion of people aged 50 years and older who are seronegative to diphtheria toxin has been recorded ( 20 ).…”

Section: Discussionmentioning

confidence: 99%

“…The main mechanism for protecting infants under two months of age from many infections, including diphtheria, tetanus, and pertussis, is the transplacental transfer of maternal immunoglobulin G (IgG) antibodies ( 3 , 9 , 10 , 13 – 17 ). It should also be mentioned that protection is also obtained via the infant's own primary immunizations.…”

Section: Introductionmentioning

confidence: 99%

Diphtheria, tetanus, and pertussis immunity among healthcare professionals and pregnant women in the Moscow region, Russian federation: A preliminary cross-sectional study

Басов

Zhernov²,

Kashutina³

et al. 2023

Front. Pediatr.

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Despite more than 50 years of primary immunization against diphtheria, pertussis, and tetanus in Russia, complicated illnesses, including fatal ones, still occur. The goal of this preliminary cross-sectional study is to see how well pregnant women and healthcare workers are protected against diphtheria, pertussis, and tetanus. The required sample size (pregnant women and healthcare professionals, as well as pregnant women of two age categories) for this preliminary cross-sectional study was calculated using a confidence value of 0.95 and a probability of 0.05. The required number of participants in each group calculated sample size must be at least 59 people. In the Moscow region (Solnechnogorsk city, Russia), a cross-sectional study of pregnant patients and healthcare professionals interacting with children regularly as part of their job from numerous medical organizations was conducted in the year 2021 (n = 655). Antibodies to diphtheria, tetanus, and pertussis toxoids and microorganisms were measured using an enzyme-linked immunosorbent assay (ELISA). The STATISTICA and IBM SPSS Statistics 26.0 were used to process the study results statistically. Descriptive statistics methods, the Mann–Whitney U-test, discriminant analysis with the stepwise selection and analysis of ROC-curves were applied. IgG against diphtheria was found in 99.5% of pregnant women, tetanus in 91.5%, and pertussis in only 36.5%. According to the results of the discriminant analysis, the value of IgG to pertussis is linked to the value of IgA to pertussis and the gestational periods. Immunity to diphtheria was discovered in 99.1% of medical personnel, tetanus in 96.9%, and pertussis in 43.9%, no significant variations with age. When comparing the levels of immunity of pregnant women and healthcare professionals, it was shown that healthcare workers have greater levels of immunity against diphtheria and tetanus. The novel contribution of this study is that it will reveal the proportion of those vulnerable to pertussis, diphtheria, and tetanus among health workers and pregnant women in all age groups under the current national immunization program in Russia. Considering the data obtained from the preliminary cross-sectional study, we believe that it is necessary to conduct a full-scale study on a larger sample and, based on that, make certain changes to the national immunization program in Russia.

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