title: Vaccination and perinatal infection prevention practices among obstetrician-gynecologists.
abstract: OBJECTIVE
  To assist efforts to improve adult vaccination coverage by characterizing vaccination and infectious disease screening practices of obstetrician-gynecologists.
  
  
  METHODS
  A written survey of demographics, attitudes, and practices was mailed to 1063 American College of Obstetricians and Gynecologists Fellows, including the Collaborative Ambulatory Research Network (n = 413) and 650 randomly sampled Fellows.
  
  
  RESULTS
  Seventy-four percent of Collaborative Ambulatory Research Network members and 44% of nonmembers responded. A majority (Collaborative Ambulatory Research Network members: 60%; nonmembers: 49%) considered themselves primary care providers. Fewer than 60% routinely obtained patient vaccination or infection histories. Most screened prenatal patients for hepatitis B surface antigen (89%) and rubella immunoglobulin G antibody (85%). Sixty-four percent worked in practices that offered at least one vaccine; the most common were rubella (52%) and influenza (50%). Ten percent worked in practices that offered all major vaccines recommended for pregnant or postpartum women. Despite recommendations to provide influenza vaccine to pregnant women during influenza season, only 44% did so; among those who did not, 14% reported a belief that pregnant women do not need influenza vaccine. Provision of vaccine was associated with working in a multispecialty practice (adjusted odds ratio [OR] 2.6, 95% confidence interval [CI] 1.6, 4.1) and identifying as a primary care provider (adjusted OR 1.9; 95% CI 1.3, 2.7). The most common reasons for not offering vaccines were cost (44%) and a belief that vaccines should be provided elsewhere (41%).
  
  
  CONCLUSIONS
  The high proportion of obstetrician-gynecologists who do not offer vaccines or screen for vaccine and infection histories suggests missed opportunities for prevention of maternal and neonatal infections.
authors.affiliation: National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, 30333, USA. zha6@cdc.gov
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Schrag
authors.forename: Anthony E
authors.initials: AE
authors.lastname: Fiore
authors.forename: Bernard
authors.initials: B
authors.lastname: Gonik
authors.forename: Tasneem
authors.initials: T
authors.lastname: Malik
authors.forename: Susan
authors.initials: S
authors.lastname: Reef
authors.forename: James A
authors.initials: JA
authors.lastname: Singleton
authors.forename: Anne
authors.initials: A
authors.lastname: Schuchat
authors.forename: Jay
authors.initials: J
authors.lastname: Schulkin
mesh_terms: D003140:Communicable Disease Control; D005260:Female; D006176:Gynecology; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009774:Obstetrics; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D011295:Prenatal Care; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D014481:United States; D014611:Vaccination