Hindawi Publishing Corporation Infectious Diseases in Obstetrics and Gynecology Volume 2006, Article ID 87040, Pages 1–5 DOI 10.1155/IDOG/2006/87040 Clinical Study Attitudes of US Obstetricians Toward a Combined Tetanus-Diphtheria-Acellular Pertussis Vaccine for Adults Sarah J. Clark,1 Soukaina Adolphe,1, 2 Matthew M. Davis,1, 3, 4 Anne E. Cowan,1 and Katrina Kretsinger5, 6 1 Child Health Evaluation and Research Unit, University of Michigan, Ann Arbor, MI 48109, USA 2 Baystate Medical Center, Springﬁeld, MA 01199, USA 3 Division of General Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA 4 Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor, MI 48109, USA 5 National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA 6 Commissioned Corps of the United States Public Health Service, USA Received 1 June 2006; Accepted 17 August 2006 Objective. To describe obstetricians’ perspectives related to tetanus-diphtheria-acellular pertussis (Tdap) vaccination of mothers and other adults in close contact with infants. Methods. Mail survey of national random sample of 400 obstetricians . Results. Response rate was 54%. Most respondents would likely recommend Tdap for women during the postpartum hospital stay (78%) or during pregnancy (69%) if a national recommendation was issued. Expected barriers were knowing the date of patients’ most recent Td booster (74%) and patient resistance (46%). Most felt that obstetricians have a role in promoting and administering Tdap vaccine to adults other than mothers likely to come in close contact with infants. Conclusion. Obstetricians are likely to agree with the recent provisional US recommendation to administer Tdap to postpartum mothers and other adults expected to come in close contact with infants. Obstetricians would also be likely to support a potential recommendation to administer Tdap during pregnancy. Barriers to adoption of new Tdap vaccine recommendations should be monitored. Copyright © 2006 Sarah J. Clark et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. INTRODUCTION Pertussis is a highly communicable infection that carries sub- stantial morbidity. The incidence of reported pertussis is in- creasing in all age groups, with over 25000 cases reported to the Centers for Disease Control and Prevention (CDC) in 2004 [1]. Infants, especially those who have not yet received the routine three-dose primary series of diphtheria-tetanus- pertussis vaccine, are particularly vulnerable to severe com- plications and death from pertussis [2], and often become infected through exposure to infected adults [3]. The ability to vaccinate adults against pertussis would reduce morbidity among adults and help prevent transmis- sion to vulnerable infants. Prior to 2005, no pertussis vaccine was licensed in the United States for adults. In June 2005, the US Food and Drug Administration (FDA) approved li- censure for a combination tetanus-diphtheria-acellular per- tussis booster vaccine (Tdap, ADACEL, sanoﬁ pasteur) for one-time use as a single dose in persons 11–64 years of age. Tdap has been shown to be safe and immunogenic in men and nonpregnant women; no controlled trials have been con- ducted to examine the safety and immunogenicity of Tdap during pregnancy or its eﬀects on the infant immune re- sponse. Following licensure, the US Advisory Committee on Im- munization Practices (ACIP), with liaison representation from the American College of Obstetricians and Gynecolo- gists (ACOG) and other partners, deliberated regarding rec- ommendations for use of this new vaccine in adults. In par- ticular, the ACIP discussed targeting a Tdap recommenda- tion to women and other adults likely to come in close con- tact with infants. Because obstetricians are an important direct link to women who are or will soon be in close contact with infants, we undertook a study to explore their perspectives regarding potential administration of Tdap to postpartum mothers or pregnant women, and to other adults expected to come in close contact with infants. These data were provided to the ACIP in October 2005. METHODS Sample A national random sample of 400 obstetricians was drawn from the AMA Masterﬁle through an AMA-endorsed