Objectives. To assess perceptions of obstetrical healthcare personnel (HCP) regarding routine delivery of Tdap and influenza vaccines to pregnant and postpartum women and identify perceived barriers to vaccination. Methods. Anonymous Web-based survey of obstetricians and nurses caring for pregnant and/or postpartum women. Results. We contacted 342 HCP and received 163 (48%) completed surveys (33/142 (23%) obstetricians, 130/200 (65%) nurses). Among obstetricians, 72% and 63% thought it was “beneficial” to immunize postpartum women against influenza and pertussis, respectively. Only 8% reported vaccinating >75% of pregnant women in their care against influenza. Similarly, <1% of obstetricians reported vaccinating against pertussis. Of all HCP surveyed, 92% and 58% were familiar with ACIP recommendations for influenza and pertussis, respectively. Reported perceived barriers included patient refusal to be vaccinated, reimbursement difficulties, and discomfort in providing vaccine education. Ninety-four percent of respondents agreed that standing orders would be helpful to ensure postpartum vaccination. Conclusions. HCP were less familiar with ACIP recommendations for Tdap compared to influenza vaccines. Substantial discrepancy existed between perceived benefit of vaccination and reported immunization practices. Most identified barriers could be addressed with provider training; however, other barriers require review and changes in systematic policies related to vaccine reimbursement. 1. Introduction The Advisory Committee on Immunization Practices (ACIP) recommends influenza vaccination of pregnant or postpartum women as well as household contacts of infants of <1？year of age [1, 2]. The ACIP also recommends tetanus toxoid, reduced diphtheria toxin, and acellular pertussis vaccine (Tdap) for postpartum women and household contacts of infants [1]. Despite these recommendations, only 11% of pregnant women and approximately 25% of household contacts of high risk individuals were vaccinated against influenza in 2008 [2]. Similarly, only 5% of adult household contacts of an infant of <1 year of age received Tdap in 2008 [3]. Over the last 2 years, influenza vaccination coverage increased to 45% for 2009 monovalent H1N1 vaccine in 2009 and this was sustained for seasonal influenza vaccination in 2010 [4–6], likely secondary to mass media attention during the 2009-2010 H1N1 influenza pandemic. These recommendations exist as pertussis and influenza are highly contagious vaccine-preventable illnesses to which infants of <6 months of old are at risk for significant
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