Vaccination Practices of Obstetrician/Gynecologists

Abstract

Background. Obstetrician/gynecologists (ob/gyns) have the potential to play a critical role as vaccinators of women. Our objectives were to determine 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. Methods. An e-mail and mail survey among a national sample of ob/gyns conducted July to October 2015. Results. The response ratewas 73.2% (353/482). For PP, vaccination status was most commonly assessed for influenza (97% reported assessing), tetanus-diphtheria-acellular pertussis (Tdap) (92%), and measles-mumps-rubella (MMR) vaccines (88%). For NPP, vaccines most commonly assessed were human papillomavirus (HPV) (92%), influenza (82%), and Tdap (51%). Among the 90% of respondents reporting administering ≥1 vaccine in their practice, those most commonly administered to PP included influenza (85% reported administering) and Tdap (76%). For NPP, vaccines most commonly administered were HPV (82%), influenza (70%), and Tdap (55%). Few respondents reported administering any other vaccines to either group. Standing orders were more commonly used for influenza (66% PP, 51% NPP) than Tdap (39% PP, 37% NPP). Other evidence-based strategies for increasing vaccine uptake were less frequently used (electronic decision support, 42% PP, 38% NPP; immunization information system (IIS) to record vaccinations (13% for both) or assess vaccination status (11% PP, 12% NPP); reminder/recall, 7% PP, 9% NPP). Items most commonly reported as major barriers to stocking and administering vaccines included inadequate reimbursement for vaccine purchase (30%) and administration (25%), difficulty determining if insurance will reimburse for a vaccine (25%), upfront costs of buying vaccines (25%), and other preventive services taking precedence during time-limited visits (22%). Conclusion. While most ob/gyns administer vaccines, the focus remains on influenza and Tdap for PP and HPV for NPP. Perceived barriers were primarily financial. Identifying and implementing strategies for ob/gyn practices will help to increase adult vaccination uptake.