Pertussis immunization rates increase with changes to hospital orders

Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center published study results on Monday that showed changing the hospital orders for postpartum women led to a 69 percent increase in pertussis vaccinations.

The study, which was published in the American Journal of Obstetrics & Gynecology, was the first to compare two hospitals' procedures, according to lead researcher Sylvia Yeh. In the hospitals included in the study, one followed standard procedure and the other implemented a physician order for new mothers to receive the vaccination before discharge.

The study showed the baseline vaccination rate to be at zero. When the physician opt-in order was implemented, the immunization rate increased to 18 percent. When the standing order was implemented, the immunization rate increased to 69 percent.

The hospital that followed standard procedure did not experience a vaccination increase.

"Vaccinating mothers of newborns holds the promise to reduce the risk of whooping cough among infants," Yeh said. "Our study found a simple change in a hospital's standing orders can make a profound difference in the immunization rates of mothers of newborns and provide vital protection to their babies and the rest of their families."

The tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine immunization is recommended for all children 2, 4, 6 years of age, as well as 15-18 months of age, according to the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices.

The ACIP recommended women receive Tdap vaccinations in the later part of the second trimester or during the third trimester of pregnancy. The committee reported that less than 3 percent of unimmunized pregnant women received the vaccination.

"Based on our study, hospitals could greatly improve immunization rates and lower risks for newborns by having standing orders for new mothers to receive Tdap vaccinations if they have not received them during pregnancy," Yeh said. "The mothers are likely to agree to be vaccinated if they receive information on the importance of being immunized to protect their children."