Your SlideShare is downloading. ×
0
A Descriptive Study of Vaccinations Occuring During Pregnancy HENNINGER
A Descriptive Study of Vaccinations Occuring During Pregnancy HENNINGER
A Descriptive Study of Vaccinations Occuring During Pregnancy HENNINGER
A Descriptive Study of Vaccinations Occuring During Pregnancy HENNINGER
A Descriptive Study of Vaccinations Occuring During Pregnancy HENNINGER
A Descriptive Study of Vaccinations Occuring During Pregnancy HENNINGER
A Descriptive Study of Vaccinations Occuring During Pregnancy HENNINGER
A Descriptive Study of Vaccinations Occuring During Pregnancy HENNINGER
A Descriptive Study of Vaccinations Occuring During Pregnancy HENNINGER
A Descriptive Study of Vaccinations Occuring During Pregnancy HENNINGER
A Descriptive Study of Vaccinations Occuring During Pregnancy HENNINGER
A Descriptive Study of Vaccinations Occuring During Pregnancy HENNINGER
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

A Descriptive Study of Vaccinations Occuring During Pregnancy HENNINGER

333

Published on

Pharmacoepidemiology

Pharmacoepidemiology

0 Comments
1 Like
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
333
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
14
Comments
0
Likes
1
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  1. A Descriptive Study of Vaccinations Occurring During Pregnancy Allison Naleway, Rachel Gold, Michelle Henninger, Samantha Kurosky, Karen Riedlinger (Kaiser Permanente Center for Health Research) James Nordin, Elyse Kharbanda (HealthPartners Research Foundation) James Donahue (Marshfield Clinic Research Foundation) Eric Weintraub (Centers for Disease Control and Prevention) HMORN Annual Meeting, Seattle, April 2012© 2012, KAISER PERMANENTE CENTER FOR HEALTH RESEARCH
  2. Background/Aims  Trivalent influenza vaccine (TIV) is the only vaccine recommended by the Advisory Committee on Immunization Practices (ACIP) for routine administration during pregnancy.  The ACIP categorizes the remaining vaccines as:  Should be considered if otherwise indicated (e.g., TD/DT, HepB)  Contraindicated (e.g., MMR, Varicella, LAIV, Rubella)  Special/conditional recommendations (e.g., HepA, TDAP/TDAP/DTP) or no recommendations (Hib)  The aim of this study was to describe rates of vaccination during pregnancy within the Vaccine Safety Datalink population, 2002-2006.© 2012, KAISER PERMANENTE CENTER FOR HEALTH RESEARCH
  3. Vaccine Safety Datalink  Collaboration between CDC, AHIP, and 10 managed care organizations  Epidemiologic studies of vaccine safety using large, standardized datasets  Datasets include demographics, enrollment, diagnoses, procedures, vaccinations  Supplemented with vital statistics data (births, deaths), Census data© 2012, KAISER PERMANENTE CENTER FOR HEALTH RESEARCH
  4. Vaccine Safety Datalink© 2012, KAISER PERMANENTE CENTER FOR HEALTH RESEARCH
  5. Methods  7 participating sites: Group Health Cooperative; Health Partners; Marshfield Clinic; and Kaiser Permanente Northwest, Northern California, Southern California, and Colorado  Using the VSD Pregnancy Episode Algorithm (PEA), we identified all pregnancies ending in 2002-2006, including live births, spontaneous and elective terminations, and other birth outcomes.  Then we identified all occurrences of vaccinations given during the same time period  Vaccines were stratified into four categories based on ACIP recommendations  All apparent cases of inadvertent vaccination during pregnancy were chart reviewed, up to 100 cases per site.© 2012, KAISER PERMANENTE CENTER FOR HEALTH RESEARCH
  6. Results: Recommended vaccines  We identified 595,929 pregnancies and 68,839 vaccinations  As expected, the most commonly administered vaccine was TIV, which is recommended during pregnancy:  58,683 doses (98.47 doses per 1,000 pregnancies)  More likely to be administered in 2nd and 3rd trimesters  1st trimester rate: 22 per 1,000  2nd trimester rate: 52 per 1,000  3rd trimester rate: 46 per 1,000© 2012, KAISER PERMANENTE CENTER FOR HEALTH RESEARCH
  7. Results: Consider if indicated vaccines Total doses Rate per 1,000 pregnancies Tetanus-diphtheria (TD/DT) 3,960 6.65 Hepatitis B 2,567 4.31 Meningococcal 192 0.32 Rabies 24 0.04 Category total 6,743 11.32© 2012, KAISER PERMANENTE CENTER FOR HEALTH RESEARCH
  8. Results: Consider if indicated vaccines (incidence rates per 1,000 pregnancies) 1st 2nd 3rd trimester trimester trimester Tetanus-diphtheria 4.11 2.03 1.23 (TD/DT) Hepatitis B 3.03 1.09 0.55 Meningococcal 0.25 0.07 0.03 Rabies 0.03 0.01 0.01 Category total 7.42 3.20 1.82© 2012, KAISER PERMANENTE CENTER FOR HEALTH RESEARCH
  9. Results: Contraindicated vaccines Total doses Rate per 1,000 pregnancies MMR 380 0.64 Varicella 291 0.49 Influenza (LAIV) 116 0.19 Rubella 92 0.15 Category total 882 1.48© 2012, KAISER PERMANENTE CENTER FOR HEALTH RESEARCH
  10. Results: Contraindicated vaccines (incidence rates per 1,000 pregnancies) 1st 2nd 3rd trimester trimester trimester MMR 0.48 0.09 0.12 Varicella 0.35 0.11 0.07 Influenza (LAIV) 0.15 0.02 0.03 Rubella 0.04 0 0.14 Category total 1.02 0.22 0.36© 2012, KAISER PERMANENTE CENTER FOR HEALTH RESEARCH
  11. Conclusions  TIV, which is recommended during pregnancy, was the most commonly administered vaccine in the VSD study population  MMR, varicella, and LAIV were the most commonly administered contraindicated vaccines  With the exception of TIV, all other vaccines were more likely to be administered during the 1st trimester of pregnancy, suggesting that vaccines may have been given when either the woman and/or provider were unaware of pregnancy  Given that some women received contraindicated vaccines during later pregnancy, clearer recommendations and improved provider education may be warranted© 2012, KAISER PERMANENTE CENTER FOR HEALTH RESEARCH
  12. Acknowledgements  CDC  KP Southern California  Julianne Gee  Craig Cheetham  Eric Weintraub  Lina Sy  Natalie McCarthy  KP Colorado  Group Health Cooperative  Simon Hambidge  Lisa Jackson  JoAnn Shoup  Patti Benson  Health Partners  KP Northwest  Jim Nordin  Jill Mesa  Elyse Kharbanda  Eresha Bluth  Gabriela Vazquez-Benitez  KP Northern California  Leslie Kuckler  Nicola Klein  Marshfield Clinic  Roger Baxter  James Donahue  Pat Ross  Stephanie Irving© 2012, KAISER PERMANENTE CENTER FOR HEALTH RESEARCH

×