Women's Healthcare and Education Coalition

Background:
In 2007, the NJ Vaccine Preventable Disease Program (NJVPDP) began plans to implement a Tdap initiative to vaccinate new mothers in birthing hospitals. Pertussis is a vaccine-preventable disease that can be transmitted from infected adults to susceptible infants. In 2007 NJ received report of 389 cases of pertussis among women of reproductive age and 37 cases among infants < 12 months. The overall pertussis vaccine rate for 4 DTaP in NJ is 84% compared to the national rate of 85.1% (NIS 2006). The ACIP recommends administration of Tdap for postpartum women not previously vaccinated to provide personal protection and reduce the risk for transmitting pertussis to their infants. Eligible postpartum patients should also receive HPV and influenza vaccines. Providers caring for postpartum women must be aware of adult immunization recommendations and incorporate vaccination into routine medical care.

Setting:
NJ Birthing Hospitals, Federally Qualified Health Centers, Women's Ambulatory Health Centers.

Population:
Medicaid eligible or uninsured women > 19 years of age living in medically under-served communities.

Project Description:
NJVPDP formed a multi-disciplinary advisory group to meet with medical staff (OB-GYN) of hospitals and women's ambulatory care centers that care for medically underserved, low socioeconomic populations. The NJVPDP expanded the focus of the initiative to community-based Federally Qualified Health Centers (FQHCs). FQHCs more readily incorporated Tdap, HPV and influenza vaccination of post-partum women into existing vaccination practices. The initiative sought to increase provider and patient awareness of adult vaccination recommendations; improve vaccination practices and promote use of Tdap, HPV and influenza vaccine in postpartum patients.

Results/Lessons Learned:
Multiple barriers to vaccination of postpartum women exist including resistance by health care providers, concerns about liability, lack of familiarity with vaccine administration tracking and vaccine accountability. In addition, vaccination of postpartum women may still leave the infant vulnerable since the father/other household contacts may not be vaccinated.