Grant: Travel Awards - Institute Community Support

Many pregnant people are reluctant to receive recommended vaccines. In 2019, the National Advisory Committee on Immunization recommended that all pregnant people receive the Tdap (diphtheria, tetanus, and pertussis) vaccine during each pregnancy. Following this recommendation, provinces and territories gradually began offering the vaccine for free to pregnant people. This study aims to understand how this free vaccination program affects the number of pregnant people receiving the Tdap vaccine, which factors are associated with vaccination, and the reasons for not receiving the vaccine. We used data from the Surveys on Vaccination during Pregnancy, which are part of the 2019 and 2021 Childhood National Immunization Coverage Surveys. A total of more than 8000 biological mothers were included. Seven provinces and territories offered free Tdap vaccines in 2019, increasing to eleven in 2021. The vaccination rates increased from 46% to 65%. Pregnant people living in areas without the free vaccination program were less likely to be vaccinated. Mothers' place of birth, age, number of children, and type of maternity care provider were associated with vaccination. The most common reason for not getting the vaccine was not knowing it was recommended, and about 20% mentioned they did not want to receive it. Providing Tdap vaccination for free can increase vaccination rates. Increased education is needed to raise awareness and address concerns about vaccination in pregnancy. This study shows the importance of free vaccination programs and provides insights for future immunization programs.