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Infectious Disease

Tdap and RSV Vaccine Recommendations and Practices for Pregnant Patients by Health Care Providers — Fall DocStyles Survey, United States, 2023 Ayeesha Sayyad* Ayeesha Sayyad Regina Simeone Beatriz Salvesen von Essen Jessica Meeker Sascha Ellington Rebecca Hall Carrie Shapiro-Mendoza Romeo Galang Grayson Waits Katherine Fleming-Dutra

Respiratory syncytial virus (RSV) and Tdap (Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis) vaccination during pregnancy were recommended by the Centers for Disease Control and Prevention in 2023 and 2011, respectively, to reduce the risk of severe illness in infants. We used data from the 2023 DocStyles survey to describe provider practices for recommending and offering these vaccines to pregnant patients.

The Fall 2023 DocStyles survey, administered October 6 – 25, 2023, was a web-based nonprobability panel survey of U.S. Health Care Providers (HCPs). Our analysis included 1,371 respondents who reported caring for pregnant patients and were asked whether they recommended and offered Tdap and RSV vaccines to their pregnant patients. Adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) estimated associations between provider type and affirmative responses to each question. Prevalence ratios were adjusted for provider age, gender, and years practicing medicine.

Providers had a median age of 47 years and 54.0% were male. Most respondents were Family Practitioners or Internists (65.6%), while 17.8% were Obstetrician-Gynecologists, and 16.6% were Nurse practitioners or Physician Assistants. Eighty percent of providers recommended the Tdap vaccine to their pregnant patients, and 73.7% offered the vaccination onsite. In contrast, 42.2% of providers offered the RSV vaccine to their pregnant patients, and only 23.1% offered onsite vaccination. Obstetrician-Gynecologists were more likely than Family Practitioners and Internists to recommend Tdap (aPR: 3.65, 95% CI: 2.09-6.35) and RSV (aPR: 3.24, 95% CI: 2.38-4.40) vaccines to pregnant people.

Public health messaging reinforcing recommended vaccinations during pregnancy is important for both HCPs and patients. HCPs caring for pregnant people play an important role in vaccine confidence and uptake, especially for newly approved vaccines, such as RSV.