Bring on the Tdap: Oregon's Efforts to Protect the Most Vulnerable

Background:  Since 2001 Oregon’s incidence of pertussis has been greater than the national average 67% of the time. The greatest incidence of illness has been in those under 1 year, especially 0-2 months of age, and rates of hospitalization in this group have been high. Studies provide evidence that household members are responsible for more than 80% of Bordetella pertussis transmission to infants.

Objectives:  The objectives were to increase Tdap uptake to protect the most vulnerable, infants; and to assess and improve Tdap administration by Oregon birth centers.

Methods:  Since 2008 Oregon has made a concentrated effort to improve Tdap uptake and create awareness of pertussis. A one year project was implemented, which provided vaccine at no cost to public and private providers, including hospital systems. The project also created resources, promotional materials, press releases, and presentations. In 2008 the Tdap booster was added as a requirement to attend Oregon public schools starting with entry into the 7^th grade. That year all 52 Oregon hospital birth centers were surveyed regarding policies for Tdap administration to mothers before discharge with their infants from the hospital. Birth centers were resurveyed in 2010.

Results:  Through the Special Project 50,000 doses of Tdap were distributed. According to Oregon sentinel data Tdap uptake in children 12-16 doubled between the 1^st quarter of 2008 to the 4^th quarter of 2009.  Hospital birth centers with policies to provide Tdap to mothers  improved by 25%, from 40% in 2008 to 65% in 2010.

Conclusions:  A multidimensional approach is effective in improving uptake of Tdap and increasing hospital birth centers with polices for offering Tdap postpartum.