Recommendation May Increase Prenatal Partners' Vaccinations

Medscape

4 days ago

MINNEAPOLIS — The partners of pregnant patients may be more likely to get vaccinated against pertussis, COVID-19, and influenza if prenatal providers recommend it to them, according to a study presented at the American College of Obstetricians and Gynecologists (ACOG) 2025 Annual Meeting.
'Many prenatal care providers are not routinely talking about vaccinations for the support people of their pregnant patients,' presenter Laurie Griffin, MD, PhD, fellow at Women and Infants Hospital, Providence, Rhode Island, told attendees.
It's really simple to talk to partners when they are sitting in your office, Griffin said. Otherwise, it's a missed opportunity.
Meshell Stokes, MD, Ob/Gyn at Fond du Lac Regional Clinic in Fond du Lac, Wisconsin, who attended the presentation, agreed, finding the results unsurprising but important.
'This study just augmented the practice that I do of really emphasizing partner immunizations,' Stokes told Medscape Medical News .
An estimated 66% of respiratory infections in babies come from an immediate family member, Griffin said, so using cocooning — vaccinating other family members against diseases — can be an effective strategy to reduce the risk of these infections in newborns.
ACOG, the American Academy of Pediatrics, and the Centers for Disease Control and Prevention all recommend maternal vaccination to provide passive immunity via placental transfer. All three organizations also recommend that all neonatal caregivers be vaccinated against pertussis, COVID-19, and flu at least 2 weeks before delivery as a strategy to protect infants.
Yet partners of pregnant patients may not realize they need the vaccines without a recommendation from a healthcare provider. Griffin, therefore, conducted two anonymous electronic surveys, one of providers and one of patients' partners, to find out how commonly these recommendations are made in regular clinical practice.
The first survey was sent to 200 obstetricians, maternal-fetal medicine specialists, prenatal family medicine providers, prenatal nurse practitioners, and certified nurse midwives in Rhode Island, and it had a 52% response rate.
'What we found is that people are really good at talking about vaccination for pregnant patients,' Griffin said. 'They are really bad at doing it for non-birthing partners.'
Among the respondents, 90% said they always recommend these vaccinations to their pregnant patients, while only a little over 30% said they always recommend them to the patients' partners. Instead, 44% of respondents reported that they 'never,' 'sometimes,' or only 'about half of the time' recommend vaccinations to the partners.
The number-one reason that providers did not counsel non-birthing partners to get the vaccines 'was they never thought about doing it,' Griffin said.
The second survey, in English or Spanish, queried 525 non-birthing partners during their partners' postpartum hospitalization and had a 63% response rate (n = 380). The respondents were an average age of 33 years, and 95.8% were men. They were racially diverse: 13% Black, 10.9% Asian, 13% multiracial, and 77% White, and nearly a quarter (23.9%) were Hispanic/Latino. Nearly half (47.9%) had a college education, and most (84.8%) were employed. Most (77.6%) also had their own primary care provider, and 88.2% attended at least one prenatal visit with their partner.
Among these non-birthing partners, 69.4% had gotten the Tdap vaccine, 80.6% received at least one complete series of COVID-19 vaccination, and 43.9% had gotten the flu vaccine. These numbers were generally higher than the approximately 35%-40% of Americans who get these vaccines.
However, the survey results suggested they could be even higher. The most common reason partners gave for not getting the Tdap was that they didn't know it was needed, cited by 46.6% of respondents. Partners seemed more aware of the recommendation for other vaccines. Only 3.7% of those who didn't get the COVID vaccine and 10.5% of those who didn't get the flu vaccine said they didn't know it was needed.
Another top reason was feeling they did not need the vaccine because they were healthy, cited by 12.3% of those who didn't get the Tdap, 25.9% who didn't get the COVID-19 vaccine, and 31.9% who didn't get the flu vaccine. Two other top reasons for skipping the COVID-19 vaccine were being opposed to it (27.2%) and being concerned about side effects (27.2%).
Fewer respondents were opposed to the Tdap (4.1%) or flu vaccine (12.4%), and fewer were concerned about side effects for Tdap (6.9%) or the flu vaccine (10%). Less frequently reported reasons — all reported by fewer than 6% of respondents for each vaccine — included not liking needles, not having a provider, not having the time or transportation, or the vaccine costing too much.
Over half the partners (60.8%) said they were counseled to get vaccinated by their partner's prenatal provider, but the other 39.2% were not. The researchers calculated that prenatal counseling on vaccination increased the likelihood that partners got vaccinated anywhere from 17% to 80%, depending on whether it was the Tdap (prevalence ratio [PR], 1.28), flu (PR, 1.8), or COVID (PR, 1.17) vaccine.
When asked how likely they would be to accept a vaccine that a prenatal provider recommended to protect their newborn, over half the partners (57.2%) said they would be likely to accept it and 15.5% said maybe. About 1 in 5 (23.4%) said they would not. These numbers suggest 'an opportunity to really discuss with people the importance of [vaccination] to protect their child,' Griffin said. A substantial majority of partners (88.5%) said they would get a vaccine if it were offered there in the office right then.
Though the respondents were representative of the Rhode Island population, Griffin noted the findings may not be generalizable to all areas. In addition, while the anonymous design of the survey reduced the likelihood of social desirability bias, answers still may have been subject to recall bias, and it's not possible to say whether the provider recommendations definitely led to partners' getting vaccinated.
No external funding was noted for the study. Griffin and Stokes had no disclosures.