title: Increasing adult Tdap vaccination rates by vaccinating infant caregivers in the pediatric office.
abstract: OBJECTIVE
  To increase adult caregiver Tdap vaccination rates by offering Tdap vaccine during infant well-child visits.
  
  
  METHODS
  We developed a pilot vaccine initiative wherein pediatricians offered Tdap vaccine to mothers and non-mother caregivers attending the 2-week well-child visit at a hospital-based clinic serving predominantly low-income families. We evaluated this initiative by asking mothers and caregivers to participate in a survey after the 2-week visit to determine self-reported Tdap vaccination status, demographics, and the source of their adult primary care.
  
  
  RESULTS
  Seventy (69%) participants received the Tdap vaccine during the newborns' 2-week well-child visit. Forty-six percent of the infants' 152 adult household contacts were vaccinated through this initiative. Of those mothers and caregivers, more caregivers reported not having insurance (38% vs 15%, P < .001), and no routine medical care (23% vs 8%, P = .007).
  
  
  CONCLUSIONS
  Through this pilot initiative, we vaccinated 69% of mothers and non-mother caregivers presenting to the 2-week well-child visit. A large proportion of caregivers did not receive routine medical care or have insurance, which suggests that they otherwise may have poor access to the vaccine. Tdap vaccination in the pediatric office represents a substantial opportunity to increase vaccination rates.
authors.affiliation: Robert Wood Johnson Foundation Clinical Scholars, Yale University School of Medicine, New Haven, CT, USA. deepa.camenga@yale.edu
authors.forename: Deepa R
authors.initials: DR
authors.lastname: Camenga
authors.forename: Kelly
authors.initials: K
authors.lastname: Kyanko
authors.forename: Jadwiga
authors.initials: J
authors.lastname: Stepczynski
authors.forename: Maryellen
authors.initials: M
authors.lastname: Flaherty-Hewitt
authors.forename: Leslie
authors.initials: L
authors.lastname: Curry
authors.forename: Diana
authors.initials: D
authors.lastname: Sewell
authors.forename: Cameale
authors.initials: C
authors.lastname: Smart
authors.forename: Marjorie S
authors.initials: MS
authors.lastname: Rosenthal
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D017028:Caregivers; D003237:Connecticut; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D017057:Medically Uninsured; D010290:Parents; D011203:Poverty; D011320:Primary Health Care; D014611:Vaccination / Q000706:statistics & numerical data*; D014917:Whooping Cough / Q000517:prevention & control*
chemical_list: D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines