CIDRAP- In 2020, US maternal Tdap vaccination rates began dropping after years of steady increases

[Lance]

In 2020, US maternal Tdap vaccination rates began dropping after years of steady increases

www.cidrap.umn.edu

In 2020, US maternal Tdap vaccination rates began dropping after years of steady increases​

Meghan Holohan

Today at 3:16 p.m.
Diphtheria

Pertussis

Adult (non-flu) Vaccines


Hearing an infant gasp and whoop when sick with pertussis (whooping cough) can make any parent feel helpless. Yet such distress can be avoided when pregnant women receive the tetanus, diphtheria, and acellular pertussis (Tdap) vaccine from 27 to 36 weeks of pregnancy. This protects their babies until they’re old enough to undergo immunization.

But rates of US maternal Tdap vaccination slumped from 2020 to 2023, declining from 88.5% to 83.9%, a drop of almost 5 percentage points, a paper published last week in Vaccine noted.

“The decreases in coverage among women with births in later study years are similar to findings of recent decreases in coverage for maternal influenza vaccines and have important public health implications,” wrote the authors, led by researchers at the Kaiser Permanente Center for Health Research and the US Centers for Disease Control and Prevention (CDC).

Vaccination more likely with more healthcare visits​

From January 2016 through December 2023, the scientists looked at Tdap vaccination rates of pregnant girls and women ages 12 to 55. By examining electronic health records at 10 US health systems in the Vaccine Safety Datalink (VSD), they determined whether moms-to-be received the Tdap, flu, and COVID-19 vaccines. During the study period, 102,374 to 112,297 pregnancies occurred each year.

In 2016, 84.8% of pregnant women were vaccinated for Tdap. The number of moms-to-be vaccinated for Tdap reached its zenith in 2019, at 88.7% of pregnant women. But thereafter, vaccination rates slipped, and by 2023, only 83.9% of pregnant women received a dose.

The decreases in coverage among women with births in later study years are similar to findings of recent decreases in coverage for maternal influenza vaccines and have important public health implications.

Pregnant women ages 25 to 34 and 35 to 55 were more likely to receive a Tdap dose than those ages 12 to 17 and 18 to 24. As overall vaccination levels dipped, the gap between the groups with the highest and lowest vaccination rates narrowed.

Pregnant Asian women had the highest rates of Tdap vaccination, with 92.0% to 95.% receiving a vaccine in any year. Black women had the lowest rates of vaccination, with 78.0% to 83.6% receiving Tdap each year.

The number of times that women visited a healthcare provider during pregnancy also affected vaccination status. Those who saw a doctor fewer than 10 times were less likely to receive a Tdap dose.

“Continued efforts to promote Tdap vaccination during pregnancy, especially among specific populations with lower vaccination coverage, such as younger and non-Hispanic Black pregnant women, are essential to protect pregnant women and their infants,” the authors wrote.