Background: Obstetrician-gynecologists (ob-gyns) play a crucial role as vaccinators of pregnant women, yet little is known about their attitudes and practices in this role. Our objectives were to describe, among a nationally representative sample of ob-gyns: 1) practices and attitudes regarding vaccination of pregnant women; and 2) barriers to the use of standing orders.
Methods: An e-mail and mail survey among ob-gyns conducted March-June 2016.
Results: The response rate was 69% (331/477). Overall, 90% reported administering ≥1 vaccines to pregnant women. Almost all (97% and 95%, respectively), strongly recommend influenza (flu) and tetanus-diphtheria-acellular pertussis (Tdap) vaccines; 60% use standing orders for flu vaccination and 56% for Tdap vaccination. More (68%) always recommend Tdap vaccines to household contacts of pregnant women than flu vaccines (53%). Physician attitudes are shown in the figure.
The most significant barriers to the use of standing orders included provider concern that patients prefer to speak to them first (12% major barrier, 25% somewhat), provider belief that they should be the one to recommend vaccines (11% major, 12% somewhat), and staff discomfort because of having to answer vaccine-related questions (7% major, 17% somewhat).
Conclusion: Ob-gyn attitudinal barriers to maternal vaccination are rare, whereas barriers to use of standing orders, a highly effective strategy for increasing vaccination uptake, are common, and less than 2/3 of providers currently use them.
M. C. Lindley, None
M. Allison, None
L. Crane, None
L. Hurley, None
B. Beaty, None
M. Brtnikova, None
A. Albert, None
A. Fisher, None
A. Jiles, None
A. Kempe, None