Implementation of a Tdap Vaccination Program for Postpartum Mothers

Background:
Immunity from pertussis containing childhood vaccines wanes causing adolescent and adult populations to be susceptible to pertussis. Pertussis in adolescents and adults is frequently misdiagnosed leading to multiple medical visits, prolonged infectious periods, and increased potential of transmission to infants and the population.
With the incidence of pertussis increasing, comes an increased risk of transmission to infants without full immunity. Infants under 12 months of age make up 19% of cases and 92% of pertussis deaths in the US from 2000-2004(CDC, 2006).

Setting:
Centerpoint Medical Center, Independence MO

Population:
Target population: Postpartum women

Project Description:
A Tdap Education and Administration Program would prevent pertussis among adults and adolescents and protect the health and safety of infants and the population. A partnership was established and the most current CDC recommendations were provided to the OB physicians and management at the local hospital. A recommendation was made to provide Tdap vaccine and education to all women of childbearing age, women in the immediate postpartum period and health care providers, all of which are close contacts to susceptible infants. Tdap education and subsequent administration is high priority among public health agencies and for this project specifically among postpartum women.

Results/Lessons Learned:
CDC recommendations were presented to the groups of OB physicians and management. All supporting documentation was available for their review in addition to a presentation reinforcing current knowledge of pertussin epidemiology and transmission. A motion was put forward to include Tdap as part of all postpartum standing orders. Beginning in August 2008, this policy change went into effect.
OB offices will be targeted separately to attempt to reach women prior to pregnancy. The Health Department will partner with the Infection Control staff at this hospital to begin a mandate of Tdap vaccine for health care workers similar to their policy already in effect for influenza vaccine.