Vaccination with Tetanus, Diphtheria, and Acellular Pertussis Vaccine of Pregnant Women Enrolled in Medicaid — Michigan, 2011–2013

Details

• Journal Article:
  Morbidity and Mortality Weekly Report (MMWR)
• Personal Author:
  Housey, Michelle ; Zhang, Fan ; Miller, Corinne ; Lyon-Callo, Sarah ; McFadden, Jevon ; Garcia, Erika ; Potter, Rachel
• Description:
  In October 2011, the Advisory Committee on Immunization Practices (ACIP) first recommended the routine administration of a tetanus, diphtheria, and Acellular pertussis vaccine (Tdap) during pregnancy as a strategy to protect infants from pertussis (also known as whooping cough). This recommendation applied to women previously unvaccinated with Tdap and specified the optimal vaccination time as late second or third trimester (after 20 weeks' gestation). By vaccinating pregnant women, infants, who are at highest risk for Mortality and morbidity from pertussis, gain passive immunity from maternal antibodies transferred to them in utero. Since this recommendation was made, little has been published on the percentage of women receiving Tdap during pregnancy. In Michigan, Medicaid pays for costs of pregnancy for approximately 40% of births. Infants enrolled in Medicaid are a particularly vulnerable population; in Michigan, their all-cause Mortality is higher than that of privately insured infants. To assess vaccination coverage among pregnant women enrolled in a publicly funded insurance program in Michigan, Medicaid administrative claims data and statewide immunization information system data for mothers of infants born during November 2011-February 2013 were analyzed. This report describes the results of that Analysis, which indicated that only 14.3% of these women received Tdap during pregnancy, with rates highest (17.6%) among non-Hispanic, non-Arab whites and lowest (6.8%) among Arab women. Vaccination was related to maternal age and gestational age at birth, but not to adequacy of prenatal care. In 2013, recognizing the importance of Tdap for every pregnancy, ACIP revised its guidelines to include a Tdap dose during every pregnancy. Ensuring that all infants receive the protection against pertussis afforded by maternal vaccination will require enhanced efforts to vaccinate pregnant women.
• Subjects:
  Age Factors Diphtheria Diphtheria-Tetanus-Acellular Pertussis Vaccines Ethnicity Female Humans Medicaid Pregnancy Pregnant Women Racial Groups Risk Tetanus Vaccination Whooping Cough Young Adult

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• Source:
  MMWR Morbidity Mortal Weekly Rep. 2014; 63(38):839-842.
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• ISSN:
  0149-2195 (print) ; 1545-861X (digital)
• Pubmed ID:
  25254561
• Pubmed Central ID:
  PMC4584674
• Document Type:
  Journal Article
• Place as Subject:
  Michigan ; United States
• Pages in Document:
  4 pdf pages
• Volume:
  63
• Issue:
  38
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR)
• Main Document Checksum:
  urn:sha-512:d281336e477f353ec9157cea95660c26bc41eabc3f84dd8af05b25fdaf0f6f7c64ebd265f71c7098b018e933374ff4e0b43fdc3c68a97427045a88aabcbd38ed
• Download URL:
  https://stacks.cdc.gov/view/cdc/50706/cdc_50706_DS1.pdf
• File Type:
  [PDF - 163.55 KB ]