Vaccinations given during pregnancy, 2002-2009: a descriptive study.
BACKGROUND
A number of studies have described influenza vaccination coverage during pregnancy but few publications have described rates of other vaccinations.


OBJECTIVE
To describe vaccination rates during pregnancy in the Vaccine Safety Datalink (VSD), with particular focus on vaccinations contraindicated during pregnancy.


METHODS
Pregnancies ending in 2002 through 2009 and vaccinations administered during these pregnancies were identified in the VSD. Vaccination rates per 1000 pregnancies during the study period were calculated by vaccine type, recommendation category, pregnancy year, maternal age, and trimester. Analyses were conducted in 2012-2013.


RESULTS
In the VSD, 669,695 pregnancies and 141,389 vaccinations were identified. Trivalent inactivated influenza (TIV) was the most commonly administered vaccination (174.1 doses per 1000 pregnancies) and was most often administered during the 2nd and 3rd trimesters. The most common vaccines in the "consider if indicated" category were tetanus-diphtheria (6.1 per 1000) and hepatitis B (3.7 per 1000). Contraindicated vaccination was infrequent, and the majority of these were measles-mumps-rubella (MMR) (1.2 per 1000); varicella (1.0 per 1000); and live-attenuated influenza vaccine (LAIV) (0.3 per 1000). Both "consider if indicated" and contraindicated vaccines were more frequently administered during early pregnancy.


CONCLUSIONS
TIV was the most commonly administered vaccine. With the exception of TIV, other vaccines were most frequently administered during early pregnancy and among younger women, suggesting that vaccination may occur when the woman and/or provider are unaware of the pregnancy. Contraindicated vaccines were infrequently administered during pregnancy; however, given that some women received contraindicated vaccines later in pregnancy, clearer recommendations and improved provider education may be needed.
Center for Health Research (Naleway, Kurosky, Henninger, Gold, Irving), Kaiser Permanente Northwest, Portland, Oregon. Electronic address: allison.naleway@kpchr.org.
Allison L
AL
Naleway
Center for Health Research (Naleway, Kurosky, Henninger, Gold, Irving), Kaiser Permanente Northwest, Portland, Oregon.
Samantha
S
Kurosky
Center for Health Research (Naleway, Kurosky, Henninger, Gold, Irving), Kaiser Permanente Northwest, Portland, Oregon.
Michelle L
ML
Henninger
Center for Health Research (Naleway, Kurosky, Henninger, Gold, Irving), Kaiser Permanente Northwest, Portland, Oregon.
Rachel
R
Gold
the HealthPartners Institute for Education and Research (Nordin, Kharbanda), Minneapolis, Minnesota.
James D
JD
Nordin
the HealthPartners Institute for Education and Research (Nordin, Kharbanda), Minneapolis, Minnesota.
Elyse O
EO
Kharbanda
Center for Health Research (Naleway, Kurosky, Henninger, Gold, Irving), Kaiser Permanente Northwest, Portland, Oregon; the Marshfield Clinic Research Foundation (Irving), Marshfield, Wisconsin.
Stephanie
S
Irving
the Department of Research and Evaluation and Pharmacy Analytical Services (Cheetham), Kaiser Permanente Southern California, Downey.
T
T
Craig Cheetham
the Center for Health Research (Nakasato), Kaiser Permanente Hawaii, Honolulu, Hawaii.
Cynthia
C
Nakasato
the Institute for Health Research (Glanz, Hambidge), Kaiser Permanente Colorado.
Jason M
JM
Glanz
the Institute for Health Research (Glanz, Hambidge), Kaiser Permanente Colorado; the Community Health Pediatrics (Hambidge), Denver Health, Denver, Colorado.
Simon J
SJ
Hambidge
the Center for Health Research (Davis), Kaiser Permanente Georgia.
Robert L
RL
Davis
the Kaiser Permanente Vaccine Study Center (Klein), Oakland, California.
Nicola P
NP
Klein
the Immunization Safety Office (McCarthy, Weintraub), CDC, Atlanta, Georgia.
Natalie L
NL
McCarthy
the Immunization Safety Office (McCarthy, Weintraub), CDC, Atlanta, Georgia.
Eric
E
Weintraub
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001428:Bacterial Vaccines / Q000008:administration & dosage*; D002648:Child; D000075202:Contraindications; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy / Q000706:statistics & numerical data; D014611:Vaccination / Q000706:statistics & numerical data / Q000639:trends*; D014765:Viral Vaccines / Q000008:administration & dosage*; D055815:Young Adult
D001428:Bacterial Vaccines; D014765:Viral Vaccines