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Vaccine. 2009 Sep 18;27(41):5599-602. doi: 10.1016/j.vaccine.2009.07.030. Epub 2009 Jul 30.

Pertussis immunization in a high-risk postpartum population.

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Center for Vaccine Awareness and Research, Texas Children's Hospital, Houston, TX, United States.


We provided CDC recommended postpartum tetanus, diphtheria, acellular pertussis (Tdap) immunization to medically underserved, uninsured women in Houston through a standing order protocol. From January 7-April 30, 2008, 1129 of 1570 (72%) postpartum women (93% Hispanic; 11% < or = 19 years) received Tdap before hospital discharge. Tdap uptake was 96.2% in women without self-reported contraindications. Recall of immunization history was inaccurate in 32% of unimmunized women who reported receiving antepartum immunization. Black women refused Tdap more often than other ethnicities (24% versus 8%; P=0.003). Postpartum Tdap immunization was successfully implemented in a high-risk population through a standing order protocol. Barriers to postpartum immunization include inaccurate immunization history and the need for ongoing targeted education.

[Indexed for MEDLINE]

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