The Advisory Committee on Immunization Practices (ACIP) has focused on maternal Tdap immunization as an important means to protect neonates from pertussis infections. Unadjusted odds ratios (ORs) and adjusted odds ratios (aORs) were calculated, comparing Medicaid insurance with private insurance with respect to odds of these vaccination outcomes. All obstetric care groups except the resident-staffed clinic significantly increased maternal Tdap coverage in 2014, compared to 2013 coverage, with no further increase in 2015. Since the conclusion of this study, Florida announced that as of February 2019 “for enrollees 21 years of age and older (including pregnant women), all (Medicaid) plans elected to cover the influenza vaccine as an expanded benefit.” Removing cost and access barriers that Medicaid-insured women face might increase maternal vaccination coverage in the Medicaid population (9). Generally, Medicare prescription drug coverage (Part D) covers all commercially available shots needed to prevent illness. This varied significantly by insurance type: 96 of 140 (68.6%) women with private insurance and 27 of 201 (13.4%) with Medicaid received Tdap during the recommended time (27–36 weeks’ gestation) during pregnancy (OR = 0.07; 95% CI = 0.04–0.12, p<0.001). Pertussis-related mortality is highest among newborns, who receive the first dose of the diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccination series at age 2 months (1). The proportion of vaccinated women receiving Tdap at 27–36 weeks gestation increased from <10% in 2009 to nearly 90% in 2016, with most vaccination occurring at 27–32 weeks gestation. Ob/GYN resident trainees may uptake evolving national immunization recommendations differently. What are the implications for public health practice? The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Pertussis and influenza are associated with substantial morbidity and mortality among infants. In the United States, the cost of the Tdap vaccine depends on whether or not you have health insurance coverage. Hosmer-Lemeshow tests indicated that the data were consistent with the assumed model (all p-values >0.10) for all model specifications. Abbreviation: SD = standard deviation. We use cookies to help provide and enhance our service and tailor content and ads. This conversion might result in character translation or format errors in the HTML version. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. The cost of cost-sharing: the impact of Medicaid benefit design on influenza vaccination uptake. However, few studies have included information on receipt of Tdap and influenza vaccines during the postpartum period. Overall, 88 of 125 (70.4%) women with private insurance and 68 of 191 (35.6%) women with Medicaid received influenza vaccine during pregnancy (OR = 0.23; 95% CI = 0.14–0.38, p<0.001); overall, 90 (72.0%) women with private insurance and 83 (43.5%) with Medicaid received influenza vaccine during pregnancy or the immediate postpartum period (OR = 0.30; 95% CI = 0.18–0.49, p<0.001). The Tdap vaccine can protect adolescents and adults from tetanus, diphtheria, and pertussis. Second, there is likely to be variation in the number of times a patient was offered these vaccines depending on provider preference and the number of prenatal visits completed (5). Centers for Disease Control and Prevention. People who did not get Tdap at that age should get it as soon as possible. Effects of influenza on pregnant women and infants. An additional 25 women for whom the influenza vaccine was not indicated (because of receipt of vaccine just before pregnancy, allergy to a vaccine component, or nonavailability of the vaccine because of late presentation to prenatal care in the brief summer window when vaccine was not available) were excluded from the analysis of influenza vaccination, leaving 316 women in the analysis of influenza vaccination. The health care reform law mandates that insurance companies cover certain preventive treatments without requiring a co-payment, co-insurance or deductible. Winter K, Nickell S, Powell M, Harriman K. Effectiveness of prenatal versus postpartum tetanus, diphtheria, and acellular pertussis vaccination in preventing infant pertussis. Weekly / January 24, 2020 / 69(3);72–76, Taylor A. Merritt1; Sonja A. Rasmussen, MD2,3; Melissa A. Stoecker C, Stewart AM, Lindley MC. A computer-generated, random selection of 450 women was obtained from the population of 6,949 women with Medicaid or private insurance at the time of their delivery. Overall Tdap coverage in 2014 was 80.4%, with variation in Tdap coverage between clinics types.

The cost of the vaccine is covered under most private insurance plans. Trends in pertussis among infants in the United States, 1980–1999. Similarly, the odds of receiving influenza vaccine during pregnancy were significantly lower among women with Medicaid than among those with private insurance (aOR = 0.30; 95% CI = 0.17–0.54, p = 0.007). ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Trends in Tdap vaccination among privately insured pregnant women in the United States, 2009–2016, Diphtheria and acellular pertussis vaccine (Tdap), https://doi.org/10.1016/j.vaccine.2019.02.042. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Am J Obstet Gynecol 2012;207(Suppl):S3–8.