Vaccine attitudes and practices among obstetric providers in New York State following the recommendation for pertussis vaccination during pregnancy

Figures & data

Table 1. Demographics of surveyed obstetric providers

Demographics	N (%)	Physicians	Mid-levels	Nurses
Total providers	133	68 (51)	41 (31)	24 (18)
Gender
Male	35 (26)	35 (51)	0	0
Female	98 (74)	33 (49)	41 (100)	24 (100)
Years in practice
< 10	47 (35)	28 (41)	10 (24)	9 (38)
10 – 19	31 (23)	12 (18)	13 (32)	6 (25)
20 – 29	32 (24)	18 (26)	11 (27)	3 (12)
≥ 30	23 (17)	10 (15)	7 (17)	6 (25)
Community served^a
Rural	61 (45)	34 (50)	17 (41)	10 (42)
Urban	34 (26)	14 (21)	12 (29)	8 (33)
Suburban	58 (44)	34 (50)	17 (41)	7 (29)
Practice setting^a
Private	123 (92)	64 (94)	37 (90)	20 (83)
Academic	12 (8)	3 (4)	4 (9)	5 (21)
Patient insurance^a
Public	59 (44)	45 (66)	18 (44)	13 (54)
Private	92 (69)	28 (41)	28 (68)	17 (71)
Provider gets annual influenza vaccine
Always	99 (74)	56 (82)	29 (71)	14 (58)
Sometimes	23 (17)	7 (10)	8 (20)	8 (33)
Never	11 (8)	3 (4)	4 (9)	2 (8)

^aPercentages for community served, practice setting, and patient insurance add up to more than 100 because multiple answers could be given for these questions.

Table 2. Vaccine attitudes and practices of surveyed obstetric providers

Provider characteristic	N (%)	Physician (%)	Midlevel (%)	Nurse (%)	p
Total enrolled	133	68	41	24
Knows pertussis vaccine recommended for all eligible women in the 3rd trimester of each pregnancy	123 (92)	62 (91)	37 (90)	24 (100)	>0.05
Believes pertussis vaccine is safe for pregnant women	118 (89)	59 (87)	39 (95)	20 (83)	>0.05
Believes pertussis vaccine is effective for pregnant women	116 (87)	59 (87)	37 (90)	20 (83)	>0.05
Recommends pertussis vaccine to all eligible pregnant women	107 (80)	53 (78)	33 (80)	21 (88)	>0.05
Administers pertussis vaccine in the office	89 (67)	41 (60)	28 (68)	20 (83)	>0.05
Knows influenza vaccine is recommended for all eligible pregnant women	133 (100)	68 (100)	41 (100)	24 (100)	>0.05
Believes influenza vaccine is safe for pregnant women	127 (95)	66 (97)	40 (98)	21 (88)	>0.05
Believes influenza vaccine is effective for pregnant women	123 (92)	61 (90)	40 (98)	22 (92)	>0.05
Recommends influenza vaccine to all eligible pregnant women	126 (95)	64 (94)	39 (95)	23 (96)	>0.05
Administers influenza vaccine in the office	113 (85)	56 (82)	35 (85)	22 (92)	>0.05
Refers patient elsewhere for vaccines	53 (40)	30 (44)	18 (44)	8 (33)	>0.05
Discusses pediatric immunizations with pregnant women	8 (6)	6 (9)	1 (2)	1 (4)	>0.05

Table 3. Summary of common responses provided by surveyed obstetric providers who do not administer vaccines in the office

Reasons why vaccines are not administered in the office	N (%)^a	Physician (%)^a	Midlevel (%)^a	Nurse (%)^a
Number who answered question	25	17	6	2
Cost	11 (44)	8 (47)	3 (50)	0
Safety concerns	5 (20)	2 (12)	3 (50)	0
Lack of reimbursement for administering vaccines	4 (16)	3 (18)	1 (16)	0
Vaccines are administered elsewhere	3 (12)	2 (12)	0	1 (50)
Lack of staff to administer vaccines	2 (8)	1 (6)	1 (16)	0
Low patient uptake	2 (8)	1 (6)	0	1 (50)
Unsure of vaccine recommendations	2 (8)	1 (6)	1 (16)	0
Uncomfortable educating patients regarding vaccines	2 (8)	1 (6)	1 (16)	0

^aPercentages add up to more than 100% because multiple answers could be given for this question.

Table 4. Factors associated with recommendation of pertussis vaccine to eligible women in the 3rd trimester of each pregnancy by surveyed obstetric providers

	Recommends pertussis vaccine (n (%))	OR	95% CI	p
	Always	Sometimes/Never
Knows pertussis vaccine recommended for all eligible women in the 3rd trimester of each pregnancy			23.33	4.58, 118.87	0.001
Yes	105 (85)	18 (15)
No	2 (20)	8 (80)
Recommends influenza vaccine to all eligible pregnant women			12.5	2.27, 68.8	0.03
Always	105 (88)	21 (17)
Sometimes/Never	2 (29)	5 (71)
Offers pertussis vaccine in the office			7.01	2.73, 17.99	<0.001
Yes	81 (76)	8 (31)
No	26 (24)	18 (69)

Table 5. Standard set of questions answered by surveyed obstetric providers

1. Did you know about the following ACIP vaccine recommendations for pregnant women

Influenza vaccine should be given to all eligible pregnant women Yes No

Pertussis vaccine should be given in the 3^rd trimester of each pregnancy Yes No

2. Circle the following vaccines you administer to pregnant women in your practice

Influenza vaccine

Pertussis vaccine

3. If you do not administer vaccines in your practice, circle the reasons:

Cost Lack of reimbursement Uncomfortable educating patients

No time to educate patients Uncertain of vaccine recommendations Safety concerns

Lack of staff to vaccinate Low uptake of vaccine by patients Other

4. Do you recommend influenza vaccine to eligible pregnant women? Always Sometimes Never

5. Do you believe the influenza vaccine is safe in pregnant women? Yes No Unsure

6. Do you believe the influenza vaccine is effective in pregnant women? Yes No Unsure

7. Do you recommend pertussis vaccine to pregnant women? Always Sometimes Never

8. Do you believe the pertussis vaccine is safe in pregnant women? Yes No Unsure

9. Do you believe the pertussis vaccine is effective in pregnant women? Yes No Unsure

10. Do you refer pregnant women elsewhere to receive vaccines? Yes No

11. Do you provide pediatric immunization information to pregnant women? Always Sometimes Never