Forum on Child and Family StatisticsVaccination: Tdap
Infants too young to be vaccinated have a disproportionate burden of pertussis-associated hospitalization.1 The Centers for Disease Control and Prevention recommends all women receive a tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine (Tdap) during each pregnancy to provide some short-term protection against pertussis (whooping cough) for their babies after they are born.4 However, approximately 45% of women in 2023 who had a recent live birth did not receive a Tdap vaccination during their pregnancy.3 Data on vaccination coverage can be used to identify groups of women who may be more likely to be unvaccinated, which can inform interventions for increasing vaccination coverage.1, 3
Figure 4: Percentage of women ages 18–49 with a recent live birth who received a Tdap vaccination during pregnancy overall by selected characteristics, 2021–2022
NH = non-Hispanic origin. Figure presents pooled data from National Health Interview Survey (NHIS) years 2012–2022. NHIS data were pooled to increase the sample size for analysis. Since 2019, questions have been included in the NHIS that can identify women ages 18–49 who had a pregnancy that ended in a live birth during the past 12 months and whether they received a Tdap vaccine during this pregnancy. Included in Other, non-Hispanic but not shown separately because of the small sample size are American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and those who reported more than one race. Fluctuations in vaccination coverage observed by race and Hispanic origin may be because of small sample sizes in certain groups. High school diploma or less education includes women with no education or any education through high school graduation as well as GED or equivalent. Some college, no degree includes women who have taken some college-level classes after high school but have not yet earned a college degree. College degree includes women who have completed an associate's degree or a bachelor's degree. More than college degree includes women who have earned a master's degree, a professional degree, or a doctoral degree. Any public includes women covered by Medicaid, Medicare, or a state-sponsored or other government-sponsored health plan. Private or military includes women who do not have public coverage but who have a military plan or any comprehensive private insurance plan (including health maintenance organizations and preferred provider organizations). These plans include those obtained through an employer, purchased directly, purchased through local or community programs, or purchased through the Health Insurance Marketplace or a state-based exchange. This classification of military plans differs from that of the National Center for Health Statistics, which classifies military plans as public insurance. The Office of Management and Budget classifies counties as within a metropolitan statistical areas (MSA). In this report, counties not classified as within an MSA are classified as nonmetropolitan. Nonmetropolitan counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas.
SOURCE: National Center for Health Statistics, National Health Interview Survey.
- In 2021–2022, among women ages 18–49 who had a live birth within the past 12 months, 67% received a Tdap vaccination during their pregnancy. There was not a statistically significant difference in Tdap coverage between 2021–2022 (67%) and 2019–2020 (66%).
- Among women in 2021–2022 with a recent live birth, women ages 18–24 (55%) had lower Tdap vaccination coverage than women ages 35–49 (76%).
- Among women in 2021–2022 with a recent live birth, Hispanic women (59%) had lower Tdap vaccination coverage than White, non-Hispanic women (71%).
- Among women in 2021–2022with a recent live birth, women who had a high school diploma or less education (52%) and those with some college education but no degree (65%) had lower Tdap vaccination coverage than those with a college degree (77%) or more than a college degree (85%).
- Among women in 2021–2022 who had a recent live birth, women with any public health insurance (59%) had lower Tdap vaccination coverage than women with private or military health insurance (75%).
- No statistically significant difference in Tdap vaccination coverage was observed between women living in a metropolitan area and women living a nonmetropolitan area.
1 Lindley MC, Kahn KE, Bardenheier BH, et al. Vital Signs: Burden and Prevention of Influenza and Pertussis Among Pregnant Women and Infants — United States. MMWR Morb Mortal Wkly Rep 2019;68:885–892.
3 Liang JL, Tiwari T, Moro P, et al. Prevention of Pertussis, Tetanus, and Diphtheria with Vaccines in the United States: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 2018;67(No. RR-2):1–44.
4 Razzaghi H, Kahn KE, Calhoun K, et al. Influenza, Tdap, and COVID-19 Vaccination Coverage and Hesitancy Among Pregnant Women — United States, April 2023. MMWR Morb Mortal Wkly Rep 2023;72:1065–1071.
Federal Interagency Forum on Child and Family Statistics
