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Pregnant and recently pregnant women are at higher risk of severe COVID-19 than other women of reproductive age, and vaccination before or during pregnancy is safe and effective. A doctor's recommendation is one of the strongest predictors that a patient will get vaccinated. So a CDC analysis of a fall 2022 survey of health care providers found a gap that matters: most recommended the vaccine, but far fewer actually offered it.
The survey
The Fall 2022 DocStyles survey, run online from August 19 to September 30, 2022, drew on a nonprobability panel of U.S. providers. Respondents practiced only in the United States, were seeing patients, had at least three years in practice, and cared for women aged 15–49. Of 2,587 eligible providers, 1,752 (68%) completed it — family practitioners and internists, obstetrician-gynecologists (ob-gyns), pediatricians, and nurse practitioners and physician assistants.
Recommending vs. offering
| All respondents | |
|---|---|
| Recommended COVID-19 vaccination to women of reproductive age | 82.9% |
| Offered or gave it on-site | 54.7% |
| — pediatricians | 65.2% |
| — ob-gyns | 41.6% |
| — providers 3–10 years in practice | 60.0% |
| — providers 20 or more years in practice | 48.9% |
One in five family practitioners and internists did not recommend COVID-19 vaccination to women of reproductive age, and one in five providers felt it was only "somewhat important" for these women to stay up to date — even though they often delay vaccination or stay unvaccinated, and vaccines and recommendations are updated frequently.
Pregnant patients
Among the 1,538 providers who cared for pregnant patients:
| Recommended | Offered or gave on-site | |
|---|---|---|
| COVID-19 vaccine | 82.9% | 53.5% |
| Influenza vaccine | 89.4% | 80.7% |
| Tdap vaccine | 78.1% | 71.9% |
Ob-gyns were the most likely to recommend COVID-19 vaccination to pregnant patients (94.2%, against 82.1% of family practitioners and internists) but the least likely to offer it on-site (39.7%, against 55.9%).
The strongest link was with other vaccines. Providers were more likely to offer COVID-19 vaccination on-site if they also recommended flu (adjusted prevalence ratio 1.8) or Tdap (1.3) vaccines — and much more likely if they already offered or gave flu vaccine on-site (5.5 times) or Tdap (2.3 times).
What would help
Providers are among the most trusted sources of vaccine information, and vaccination coverage in pregnancy is highest among women who report a provider's recommendation or offer. The authors conclude that encouraging providers to recommend, offer and give COVID-19 vaccines alongside flu and Tdap vaccines could reinforce vaccine confidence and raise coverage — protecting pregnant women and newborns from these diseases and their complications.
Limits
DocStyles is a voluntary opt-in panel, not a random sample, so results may not represent all U.S. providers. Answers were self-reported. The data are from fall 2022, and the survey did not ask why some providers don't recommend the vaccine.
Sources
Based on Mehreen Meghani, Beatriz Salvesen Von Essen, Lauren B. Zapata, et al., "COVID-19 Vaccination Recommendations and Practices for Women of Reproductive Age by Health Care Providers — Fall DocStyles Survey, United States, 2022," Morbidity and Mortality Weekly Report, volume 72, Centers for Disease Control and Prevention; a work of the United States government in the public domain.
Licença: CC0 1.0 (domínio público) · Adaptado de www.cdc.gov
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