Obstetrician-Gynecologists' Practices and Perceived Knowledge Regarding Immunization

Research Department, American College of Obstetricians and Gynecologists, Washington, DC 20024, USA.
American journal of preventive medicine (Impact Factor: 4.53). 07/2009; 37(3):231-4. DOI: 10.1016/j.amepre.2009.05.019
Source: PubMed


Obstetrician-gynecologists can play a key role in providing appropriate vaccinations to women of childbearing age.
This study investigated immunization knowledge and practices, and opinions concerning potential barriers to immunization, among obstetrician-gynecologists.
In 2007, surveys were sent to Collaborative Ambulatory Research Network members, a representative sample of practicing Fellows of the American College of Obstetricians and Gynecologists; 394 responded (51.2%). Data analysis was completed in 2008.
Most responding obstetrician-gynecologists disagreed that "routine screening for vaccine-preventable diseases falls outside of the routine practice of an ob/gyn." A majority (78.7%) stock and administer at least some vaccines. Among those who stock vaccines, 91.0% stock the human papillomavirus vaccine, and 66.8% stock the influenza vaccine. All other vaccines were stocked by <30% of practices that stock vaccines. A majority of physicians agreed that financial factors (e.g., inadequate reimbursement) were barriers to vaccine administration. Most were aware that the influenza (89.8%); hepatitis B (64.0%); and tetanus, diptheria, pertussis (58.6%) vaccines are safe to administer during pregnancy, and that the measles, mumps, rubella (97.5%); and varicella (92.9%) vaccines are not. Most (84.5%) were in concordance with recommendations that all pregnant women should receive the influenza vaccine. A majority believed their immunization training was less than adequate and believed their practice would benefit from continuing medical education courses.
Immunization is an important part of women's health care and has been, at least partially, incorporated into obstetrician-gynecologist practice. Financial burdens and knowledge regarding vaccine recommendations remain barriers to vaccine administration. Additional training and professional information may benefit obstetric-gynecologic practice.

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    • "Another barrier to recommending influenza vaccination to pregnant women might involve financial concerns, which have been consistently reported in previous surveys of obstetricians [27] and take a seminal role in low-resource countries with other competitive priorities for public health. In the present study, however, none of the obstetricians or patients cited financial reasons for not undergoing vaccination; the overriding cause of poor uptake in the present study was physicians not recommending vaccination. "
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    ABSTRACT: Objective To study the uptake of influenza vaccination among pregnant women in northern India and physicians’ beliefs and practices regarding vaccination. Methods A questionnaire-based survey was undertaken between October 2012 and April 2013. Pregnant women attending an obstetric hospital in Srinagar, India, and healthcare personnel were asked to participate. Results Among 1000 women aged 18–41 years (13.6% first trimester, 26.8% second trimester), none had been offered or received influenza vaccination. Only 9 (10.0%) of 90 obstetricians surveyed had been vaccinated for influenza in the past 5 years, although 81 (90.0%) believed that influenza could have severe consequences for themselves and their patients. The reasons cited for non-vaccination included poor knowledge about availability of vaccine and concerns about its efficacy. Sixty-six (73.3%) obstetricians believed that vaccine adverse effects are under-reported, and 79 (87.8%) believed that vaccination programs are motivated by profit. Eighty-four (93.3%) obstetricians wished to undergo vaccination in the coming flu season. Conclusion Influenza vaccination among pregnant women in northern India is nonexistent. Poor uptake is rooted in misperceptions about vaccine availability, efficacy, and safety among treating physicians, few of whom are vaccinated.
    International Journal of Gynecology & Obstetrics 12/2014; DOI:10.1016/j.ijgo.2014.05.021 · 1.54 Impact Factor
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    • "Wakefield's hypothesis stated that MMR vaccine causes a series of events including intestinal inflammation, loss of intestinal barrier function, entrance into the bloodstream of encephalopathic proteins and consequent development of autism [15]. Though it has been challenged many times, there are still doubts as to MMR safety in terms of child development [11] [12]. We estimate that our study is the first one that addresses MMR safety in wider sense beyond autism, and therefore it could be very considerable for public acceptance of immunization. "
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    ABSTRACT: Objectives: The aim of the study was to examine the hypothesis that MMR exposure has a negative influence on cognitive development in children. Furthermore, MMR was compared to single measles vaccine to determine the potential difference of these vaccines safety regarding children's cognitive development. Methods: The prospective birth cohort study with sample consisted of 369 infants born in Krakow. Vaccination history against measles (date and the type of the vaccine) was extracted from physicians' records. Child development was assessed using the Bayley Scales of Infant Development (BSID-II) up to 3rd year of life, Raven test in 5th and 8th year and Wechsler (WISC-R) in 6th and 7th year. Data on possible confounders came from mothers' interview, medical records and analyses of lead and mercury level at birth and at the end of 5th year of life. Linear and logistic regression models adjusted for potential confounders were used to assess the association. Results: No significant differences in cognitive and intelligence tests results were observed between children vaccinated with MMR and those not vaccinated up to the end of the 2nd year of life. Children vaccinated with MMR had significantly higher Mental BSID-II Index (MDI) in the 36th month than those vaccinated with single measles vaccine (103.8±10.3 vs. 97.2±11.2, p=0.004). Neither results of Raven test nor WISC-R were significantly different between groups of children vaccinated with MMR and with single measles vaccine. After standardization to child's gender, maternal education, family economical status, maternal IQ, birth order and passive smoking all developmental tests were statistically insignificant. Conclusion: The results suggest that there is no relationship between MMR exposure and children's cognitive development. Furthermore, the safety of triple MMR is the same as the single measles vaccine with respect to cognitive development.
    Vaccine 04/2013; 31(22). DOI:10.1016/j.vaccine.2013.03.057 · 3.62 Impact Factor
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    • "This national survey of obstetricians demonstrates that access to H1N1 vaccine among obstetricians was widespread. These findings, confirmed by other research [7], also show that the rate of H1N1 vaccine availability in the practice setting was higher than that seen previously for seasonal influenza vaccine [8–10], and was slightly higher than the reported availability of seasonal influenza in their practices for the 2009–2010 and 2010–2011 seasons. Obstetrician involvement may have been influenced by early reports of influenza-related mortality in pregnant women [11], as well as coordinated efforts by public health officials and professional societies, such as the American College of Obstetricians and Gynecologists (the College), to communicate to providers the importance of participating as H1N1 vaccinators [12]. "
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    ABSTRACT: Our objective was to describe the experiences of obstetricians during the 2009-2010 H1N1 vaccination campaign in order to identify possible improvements for future pandemic situations. We conducted a cross-sectional mail survey of a national random sample of 4,000 obstetricians, fielded in Summer 2010. Survey items included availability, recommendation, and patient acceptance of H1N1 vaccine; prioritization of H1N1 vaccine when supply was limited; problems with H1N1 vaccination; and likelihood of providing vaccine during a future influenza pandemic. Response rate was 66 %. Obstetricians strongly recommended H1N1 vaccine during the second (85 %) and third (86 %) trimesters, and less often during the first trimester (71 %) or the immediate postpartum period (76 %); patient preferences followed a similar pattern. H1N1 vaccine was typically available in outpatient obstetrics clinics (80 %). Overall vaccine supply was a major problem for 30 % of obstetricians, but few rated lack of thimerosal-free vaccine as a major problem (12 %). Over half of obstetricians had no major problems with the H1N1 vaccine campaign. Based on this experience, 74 % would be "very likely" and 12 % "likely" to provide vaccine in the event of a future influenza pandemic. Most obstetricians strongly recommended H1N1 vaccine, had few logistical problems beyond limited vaccine supply, and are willing to vaccinate in a future pandemic. Addressing concerns about first-trimester vaccination, developing guidance for prioritization of vaccine in the event of severe supply constraints, and continued facilitation of the logistical aspects of vaccination should be emphasized in future influenza pandemics.
    Maternal and Child Health Journal 08/2012; 17(7). DOI:10.1007/s10995-012-1104-x · 2.24 Impact Factor
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