Duke Medicine: OB/GYNs may be best place for vaccinations

Your OB/GYN's office might be the best place to get a vaccine.

The program, funded by the U.S. Centers for Disease Control, set up a system to screen patients at three OB/GYN clinics in North Carolina, including two in Raleigh, and identified patients who were eligible for the vaccines.

"We basically tried to automate the process for them," said Geeta Swamy, the director of obstetrics clinical research at Duke, who presented the findings at the CDC National Immunization Conference in Atlanta. "We put the information together, got pamphlets and we ran education programs with the office and staff."

The vaccines offered included the HPV vaccine, which prevents the virus that causes most most cases of cervical cancer and genital warts. It's recommended for girls and women ages 9 to 26.

The second was the Tdap, which guards against tetanus, diphtheria and pertussis. Rates of pertussis (commonly called whooping cough) have been on the rise in the last five years. The U.S. Centers for Disease Control and Prevention has recommended that adults and adolescents receive a newer, single dose if they haven't gotten a tetanus shot in the past two years.

The disease isn't serious in adolescents and adults, but it's life-threatening in infants because they aren't fully immunized until at least one year of age. A recent report found that mothers were the primary source of infection in 32 percent of infant pertussis cases.

So far, preliminary data from one clinic found non-pregnant women were already being offered the HPV vaccine. But post-partum women were not. When they were, the rate of vaccination jumped from 0 to 44 percent.

The numbers were even higher for the Tdap vaccine. Of the 1,000 women offered it, about 600 received it. None had been offered it before.

Swamy says that OB/GYN offices are uniquely positioned to offer these vaccines. They account for a third of all medical visits for women ages 17 to 21 years old. And they provide more primary care to adolescents and adult women than family or internal medicine.

The program should be complete by the end of the summer when Swamy and other researchers will look at the final results and decide whether it's something to recommend for all OB/GYN clinics.

But, for now, she says it's worth asking your doctor about the vaccinations.

"It clearly shows that physically discussing things with patients has a major impact," she said.