Pneumococcal Vaccination Rates Among Pregnant Patients: A Call for Improved Screening

Pneumococcal disease remains a significant health concern, particularly for individuals with certain underlying medical conditions. While clinical guidelines emphasize the importance of preventative care, new data presented at the American College of Obstetricians and Gynecologists (ACOG) Annual Clinical & Scientific Meeting reveals that vaccination rates for this preventable illness remain critically low among eligible pregnant patients.

Understanding the Risk During Pregnancy

Pregnancy induces significant physiological and immunological shifts that can increase susceptibility to respiratory infections, including severe pneumonia. For patients with qualifying medical conditions—such as HIV, congenital or acquired immunodeficiency, asplenia, chronic renal failure, sickle cell disease, chronic lung or liver disease, diabetes mellitus, or congestive heart failure—the risk of complications is notably higher.

Current clinical guidance from the American Society for Reproductive Medicine (ASRM) recommends that high-risk patients ideally complete their vaccination series prior to pregnancy. For those who remain unvaccinated, the ASRM suggests that patients aged 19 to 45 receive one dose of the 15-valent pneumococcal conjugate vaccine (PCV15) followed by the 23-valent pneumococcal polysaccharide vaccine (PPSV23), or alternatively, one dose of the 20-valent pneumococcal conjugate vaccine (PCV20).

Key Findings from Recent Research

A study presented at the ACOG meeting evaluated vaccination rates among 492 pregnant patients who received care in 2024. The findings highlight a significant gap in preventative medicine:

• Only 1% of eligible pregnant patients received the pneumococcal vaccine during their pregnancy.
• Approximately 7.7% of the cohort were considered up to date with their pneumococcal vaccination status.
• Patients with preexisting diabetes showed a higher likelihood of being up to date on vaccinations compared to those with other qualifying conditions.
• Patients living with HIV were vaccinated at lower rates compared to those without the condition.

The study, led by researchers at Thomas Jefferson University, underscores that despite the availability of vaccines with established safety and efficacy data, actual administration rates in prenatal settings are trailing behind clinical recommendations.

Improving Patient Outcomes Through Proactive Counseling

The low uptake of the pneumococcal vaccine presents an opportunity for clinicians to better integrate preventative health screenings into routine prenatal care. Because pregnant patients frequently engage with healthcare providers, these visits serve as an ideal touchpoint for assessing immunization status.

Strategies for Clinicians

• Systematic Screening: Incorporate questions about pneumococcal vaccination status into standard prenatal intake forms, similar to how providers currently screen for asthma or other chronic conditions.
• Patient Education: Address questions regarding vaccine safety and potential side effects during prenatal counseling.
• Identify Barriers: Future research is necessary to better understand patient-level and system-level barriers that prevent the administration of recommended vaccines during the prenatal period.

Conclusion

Optimizing health during pregnancy requires a comprehensive approach that extends beyond standard obstetric care. By prioritizing vaccine status reviews, physicians can help mitigate the risk of severe illness for their patients. As the medical community continues to refine its approach to maternal health, ensuring that eligible patients receive the pneumococcal vaccine remains a vital step in providing high-quality, preventative care.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with your obstetrician or primary care provider regarding your specific health needs and vaccination requirements.