Protecting Babies By Vaccinating Pregnant Women: The Development of a New Campaign to Promote Whooping Cough Vaccine during Pregnancy

Theoretical Background and research questions/hypothesis:  Pertussis (also known as whooping cough) is a very contagious disease that can be deadly for babies. In the first 6 months of life, babies are at high risk for severe complications from pertussis. Unfortunately, the U.S. has seen increasing rates of pertussis since the 1980s despite high rates of immunization with the diphtheria, tetanus, and acelluar pertussis vaccine (also referred to as DTaP) among children.  To protect children when they are most vulnerable to serious complications from pertussis, the Advisory Committee on Immunization Practices (ACIP) recommended in 2012 that pregnant women receive the tetanus, diphtheria, and acelluar pertussis vaccine (also referred to as Tdap) during the third trimester of each pregnancy so they can pass some protective antibodies for pertussis to their unborn infant.  These antibodies help protect young infants until they are old enough to receive their own pertussis vaccines starting at age two months.  CDC accepted and published the recommendation in February 2013. Because this is a relatively new vaccine recommendation, coverage rates for Tdap vaccine during pregnancy are very low.  The most recent estimate is that up to only 14% of pregnant women received Tdap during pregnancy in 2012.  Part of the reason is that awareness of this new recommendation is low among both pregnant women and their obstetric providers. CDC conducted formative research with pregnant women and OB-GYNs to inform the development of new campaign messages and materials intended to increase Tdap coverage during pregnancy. Research includes knowledge, attitudes, and beliefs about the recommendation; barriers and motivators; information needs; and reactions to draft messages and materials.

Methods:  In collaboration with the American College of Obstetrics and Gynecology and the American Academy of Pediatrics, we conducted both qualitative and quantitative research to inform campaign development, including online surveys with OB-GYNs and pregnant women; telephone and in-person in-depth interviews with OB-GYNs; and focus groups with both English- and Spanish-speaking pregnant women.  We segmented our OB-GYN audience into two groups:  OB-GYNs whose patient population is less than 50% Hispanic and those whose population is more than 50% Hispanic. Multiple campaign concepts were tested with pregnant women.

Results:  Data collection will take place during spring and summer 2014, and results will be presented at the conference.

Conclusions:  This research will lead to a suite of materials that obstetric providers can use to strongly recommend the Tdap vaccine, including educating patients on their babies’ risk of pertussis and vaccination as the best prevention strategy. The research will also inform development of materials for pregnant women to educate them about the Tdap vaccine recommendation, address any concerns about getting the vaccine while pregnant, and communicate the health threat of pertussis.

Implications for research and/or practice:  This presentation will present findings from our formative research with pregnant women and OB-GYNs and discuss how the findings were applied in the development of campaign products for each audience. The findings may offer important insights into these unique target populations, about whom little research on vaccination has been published.