Low postpartum rubella vaccination rates in high-risk women, Miami, Florida, 2001.
OBJECTIVE
To evaluate adherence to the Advisory Committee on Immunization Practices' recommendations on postpartum rubella vaccination in hospitals with a high proportion of foreign-born Latina mothers, the highest risk group for congenital rubella syndrome.


METHODS
In four large hospitals in Miami-Dade County, maternal medical records for births in 2001 were randomly selected. Using demographic information from birth certificates, vaccination information from medical records, and policy information from a hospital survey, postpartum rubella vaccination rates were characterized among women eligible for vaccination (non-immune and not screened) through univariate and multivariable analyses. Data collection was performed in 2002-2003 and the analysis was completed in 2004-2005.


RESULTS
Among 1991 women, 1209 (61%) were foreign born. Overall, 410 (21%) were eligible for vaccination, and of these 44 (11%) were vaccinated. Vaccination rates were not associated with maternal race/ethnicity or the existence of institutional standing-order vaccination policies. A vaccination order was recorded for 59% (240/410), but even in the presence of an order, only 17% (31/240) of those women were vaccinated.


CONCLUSIONS
Despite policies and standing orders to vaccinate, postpartum rubella vaccination rates were very low among all racial/ethnic subgroups in a sample of hospitals caring for high-risk, foreign-born women. These findings suggest that additional system-level interventions, such as comprehensive operational guidelines, must accompany standing orders to vaccinate rubella non-immune women postpartum.
Bloom
Sharon A
SA
National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. Blooms@nacop.net
Trepka
Mary Jo
MJ
Nobles
Robert E
RE
Becerra
Merardo A
MA
Reef
Susan
S
Zhang
Guoyan
G
D000328:Adult; D017691:Caribbean Region / Q000208:ethnology; D004641:Emigration and Immigration; D005260:Female; D005431:Florida; D006801:Humans; D007843:Latin America / Q000208:ethnology; D008403:Mass Screening; D011181:Postnatal Care; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology / Q000517:prevention & control*; D012409:Rubella / Q000276:immunology / Q000517:prevention & control; D012410:Rubella Syndrome, Congenital / Q000208:ethnology / Q000517:prevention & control*; D012411:Rubella Vaccine; D014611:Vaccination / Q000706:statistics & numerical data*
D012411:Rubella Vaccine