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Increasing Adult Tdap Vaccination Rates by Vaccinating Infant Caregivers in the Pediatric Office

  • Deepa R. Camenga
    Correspondence
    Address correspondence to Deepa R. Camenga, MD, MHS, PO Box 208088, 333 Cedar Street, IE-61 SHM, New Haven, CT 06520.
    Affiliations
    Robert Wood Johnson Foundation Clinical Scholars, Yale University School of Medicine, New Haven, Conn. (Drs. Camenga, Curry and Rosenthal); Department of Internal Medicine, New York University School of Medicine, New York, NY (Dr. Kyanko); Hospital of Saint Raphael, New Haven, Conn. (Drs. Stepczynski, Flaherty-Hewitt, Sewell and Smart); Yale School of Public Health (Dr. Curry); and Department of Pediatrics, Yale School of Medicine (Dr. Rosenthal), New Haven, Conn
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  • Kelly Kyanko
    Affiliations
    Robert Wood Johnson Foundation Clinical Scholars, Yale University School of Medicine, New Haven, Conn. (Drs. Camenga, Curry and Rosenthal); Department of Internal Medicine, New York University School of Medicine, New York, NY (Dr. Kyanko); Hospital of Saint Raphael, New Haven, Conn. (Drs. Stepczynski, Flaherty-Hewitt, Sewell and Smart); Yale School of Public Health (Dr. Curry); and Department of Pediatrics, Yale School of Medicine (Dr. Rosenthal), New Haven, Conn
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  • Jadwiga Stepczynski
    Affiliations
    Robert Wood Johnson Foundation Clinical Scholars, Yale University School of Medicine, New Haven, Conn. (Drs. Camenga, Curry and Rosenthal); Department of Internal Medicine, New York University School of Medicine, New York, NY (Dr. Kyanko); Hospital of Saint Raphael, New Haven, Conn. (Drs. Stepczynski, Flaherty-Hewitt, Sewell and Smart); Yale School of Public Health (Dr. Curry); and Department of Pediatrics, Yale School of Medicine (Dr. Rosenthal), New Haven, Conn
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  • Maryellen Flaherty-Hewitt
    Affiliations
    Robert Wood Johnson Foundation Clinical Scholars, Yale University School of Medicine, New Haven, Conn. (Drs. Camenga, Curry and Rosenthal); Department of Internal Medicine, New York University School of Medicine, New York, NY (Dr. Kyanko); Hospital of Saint Raphael, New Haven, Conn. (Drs. Stepczynski, Flaherty-Hewitt, Sewell and Smart); Yale School of Public Health (Dr. Curry); and Department of Pediatrics, Yale School of Medicine (Dr. Rosenthal), New Haven, Conn
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  • Leslie Curry
    Affiliations
    Robert Wood Johnson Foundation Clinical Scholars, Yale University School of Medicine, New Haven, Conn. (Drs. Camenga, Curry and Rosenthal); Department of Internal Medicine, New York University School of Medicine, New York, NY (Dr. Kyanko); Hospital of Saint Raphael, New Haven, Conn. (Drs. Stepczynski, Flaherty-Hewitt, Sewell and Smart); Yale School of Public Health (Dr. Curry); and Department of Pediatrics, Yale School of Medicine (Dr. Rosenthal), New Haven, Conn
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  • Diana Sewell
    Affiliations
    Robert Wood Johnson Foundation Clinical Scholars, Yale University School of Medicine, New Haven, Conn. (Drs. Camenga, Curry and Rosenthal); Department of Internal Medicine, New York University School of Medicine, New York, NY (Dr. Kyanko); Hospital of Saint Raphael, New Haven, Conn. (Drs. Stepczynski, Flaherty-Hewitt, Sewell and Smart); Yale School of Public Health (Dr. Curry); and Department of Pediatrics, Yale School of Medicine (Dr. Rosenthal), New Haven, Conn
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  • Cameale Smart
    Affiliations
    Robert Wood Johnson Foundation Clinical Scholars, Yale University School of Medicine, New Haven, Conn. (Drs. Camenga, Curry and Rosenthal); Department of Internal Medicine, New York University School of Medicine, New York, NY (Dr. Kyanko); Hospital of Saint Raphael, New Haven, Conn. (Drs. Stepczynski, Flaherty-Hewitt, Sewell and Smart); Yale School of Public Health (Dr. Curry); and Department of Pediatrics, Yale School of Medicine (Dr. Rosenthal), New Haven, Conn
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  • Marjorie S. Rosenthal
    Affiliations
    Robert Wood Johnson Foundation Clinical Scholars, Yale University School of Medicine, New Haven, Conn. (Drs. Camenga, Curry and Rosenthal); Department of Internal Medicine, New York University School of Medicine, New York, NY (Dr. Kyanko); Hospital of Saint Raphael, New Haven, Conn. (Drs. Stepczynski, Flaherty-Hewitt, Sewell and Smart); Yale School of Public Health (Dr. Curry); and Department of Pediatrics, Yale School of Medicine (Dr. Rosenthal), New Haven, Conn
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      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.

      Keywords

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