Abstract:
Background: The Tetanus, Diphtheria and Acellular Pertussis vaccine (Tdap) for pregnant
women was recommended by the Advisory Committee on Immunization Practices (ACIP) in
2012 to reduce pertussis morbidity and mortality in infants. The objective of the capstone study
was to compare pregnant Hispanic women who preferred to communicate in English with those
who preferred to communicate in Spanish within the context of their decision to accept or reject
third-trimester Tdap vaccination. Method: Using the electronic medical record, a retrospective
review was conducted to evaluate patient decisions about the Tdap vaccination among 386
Hispanic women who received prenatal care between 27 and 36 weeks in a large southwestern
public health care system starting in June 1, 2013 through December 2, 2013. Results: After
exploring any potential relationships of covariates to the dependent variable, logistic regression
was used to explore the effect of the preference to communicate in English versus preference to
communicate in Spanish on the decision to accept Tdap vaccination during pregnancy. Of all the
predictor variables, only education level and number of total clinic visits were significant
predictors of a decision to accept vaccination. Higher attainment of education increased the
likelihood of accepting the Tdap vaccine increases. In addition, as the total number of clinic
visits increased, the likelihood of accepting the Tdap vaccine also increased. The independent
variable, Language, however, was not a significant predictor of accepting Tdap vaccination (p =
.785). However, the model overall, was statistically significant, χ2
(7) = 40.22, p < .001, but with
a relatively low predictive power, Nagelkerke R
2
= .163.
