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The Obstetrician-Gynecologist’s Role in Vaccine-Preventable Diseases and Immunization

From the Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan; Michigan State University Extension Program, East Lansing, Michigan; and Division of Immunization, Michigan Department of Community Health, Lansing, Michigan.

Address reprint requests to: Bernard Gonik, MD, Department of Obstetrics and Gynecology, Wayne State University School of Medicine, 6071 W. Outer Drive, Detroit, MI 48235, E-mail: bgonik{at}dmc.org

Objective: To assess by survey the immunization role currently played by obstetrician-gynecologists in the state of Michigan.

Methods: Masked questionnaires requesting demographic, knowledge-based, practice, and attitudinal data were sent to 850 ACOG-registered fellows.

Results: Three hundred sixty-five physicians responded, 313 of whom were in active practice. Most were male (70%) and graduated from medical school between 1970 and 1989 (68%). The majority provided both obstetric and gynecologic services. The minority (47%) specifically identified themselves as primary care providers. Only 15% of respondents considered screening for vaccine-preventable diseases to be outside the realm of routine obstetric-gynecologic care. In practice, however, 19% did not screen their obstetric patients for any vaccine-preventable diseases, and only 10% assessed their patients for all nine vaccine-preventable diseases listed in the questionnaire. In gynecologic patients, almost 40% of physicians did not assess for any vaccine-preventable disease. A wide range in knowledge level was identified concerning vaccine-preventable diseases, immunization recommendations, and vaccine safety.

Conclusion: These data show a discrepancy between perceived responsibilities and actual practice patterns of obstetrician-gynecologists regarding vaccine-preventable diseases and the immunization of women. Limitations in current knowledge and practical concerns specific to vaccine administration contribute to this disparity.

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