Article

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: 4.28). 07/2009; 37(3):231-4. DOI: 10.1016/j.amepre.2009.05.019
Source: PubMed

ABSTRACT 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 · 1.56 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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    • "[9] This is supported by The American College of Obstetricians and Gynaecologists' Committee on Obstetric Practice. [18] A recent literature review performed by Skowronski et al. [6] found that TIV is warranted to protect women against influenza-related hospitalization during the second half of normal pregnancy, but evidence is otherwise insufficient to recommend routine TIV as the standard of practice for all healthy women beginning in early pregnancy. [6] Similarly, another review looked at the evidence for the risks of influenza and the risks and benefits of seasonal influenza vaccination in pregnancy and concluded that data on influenza vaccine safety in pregnancy is inadequate. "
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