Maternal Self-Report of Tdap Vaccination During Pregnancy Correlates with Patient-Specific Electronic Medical Records

Objectives To evaluate the concordance between maternal report of antepartum Tdap vaccination and vaccination status documented in the electronic medical record (EMR), as well as factors associated with discordance. Study design A survey was completed by a convenience sample of postpartum patients in a New York metropolitan hospital. The survey collected patients’ demographic information, health beliefs, and whether they received Tdap vaccine during this pregnancy. The patient’s Tdap vaccination status was abstracted from the EMR, a combination of data gathered from the obstetrician and patient’s hospital record. Kappa statistics measured the agreement between maternal report and EMR on antepartum Tdap vaccination. Univariate and multivariable logistic regression analyses were performed to identify maternal characteristics associated with discordance. Results Of the 1,571 patients with Tdap status available in the EMR, 1,549 patients (92%) reported on receipt status for Tdap vaccination during pregnancy. 1,328 maternal reports (86%) agreed with the EMR for Tdap status (kappa = 0.72, 95% CI 0.68-0.75). Several factors were statistically significant in multivariable analyses: lower income was associated with greater discordance (i.e., over-reporting; p=0.02), as well as certain health beliefs including “Pregnant women should be concerned about the possibility of pertussis in their babies” (adjusted OR [aOR] 2.86, 95% CI 1.02-8.04) and “My friends would probably think getting a Tdap vaccine is a good idea” (aOR 2.36, 95% CI 1.11-4.99). Conclusion Maternal recall of Tdap vaccination during pregnancy is consistent with the EMR. This supports the value of maternal report in determining Tdap vaccination status, which is especially important when vaccination records are not available.