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Only about a third of pregnant women said they received both the flu shot and the tetanus, diphtheria, and acellular pertussis (Tdap) vaccines during pregnancy, though both vaccines have been proven safe and effective for pregnant women, CDC researchers said.

In spring 2019, only 35% of pregnant women reported receiving both the influenza vaccine and the Tdap vaccine during pregnancy, even though about 74% of women said that their healthcare provider offered to either give them the vaccine or make a referral.

The most frequent reasons for refusing the flu shot were not believing the vaccine was effective, and for the Tdap vaccine, that they had already received the vaccine and did not know it was recommended during every pregnancy.

In a conference call with the media, CDC principal deputy director Anne Schuchat, MD, said there is room for improving communication between clinicians and pregnant women, and that healthcare providers should ensure that vaccination is a routine part of prenatal care.

"We're learning a lot about improved communication [between clinicians and patients]," she told MedPage Today. "Begin those conversations early -- it may not be flu season, it may not be the third trimester [for the Tdap vaccine], but start talking to patients early in their pregnancy, provide them information to read between appointments so that when the time comes, they'll be able to make a good choice."

Schuchat added that vaccination uptake is higher among patients where providers are able to vaccinate in the office rather than make a referral outwards and "a strong recommendation from a clinician is important."

She also encouraged clinicians to talk about the child's vaccinations during the prenatal visit, to prepare the patient for after the child is born -- infants should get their first dose of diphtheria, tetanus, and pertussis (DTaP) vaccine at age 2 months, and their first flu shot at age 6 months.

During the call, Schuchat also emphasized the importance of clinicians sharing their own personal experiences and medical experience, and for female clinicians, that they were vaccinated during their pregnancies.

"Explain the benefit of vaccination and the risks of not getting vaccinated," she said, adding that "high-quality scientific studies" have proven the safety and effectiveness of vaccines during pregnancy.

In an accompanying Vital Signs edition of the , Megan C. Lindley, MPH, of the CDC, and colleagues examined data from an Internet panel survey from March to April 2019 among women ages 18-49 who had been pregnant at any point since August 2018, as well as data from pregnant women reported to FluSurv-NET from 2010-2011 to 2017-2018.

Among the 2,626 women who completed the survey (including 2,097 who were pregnant during flu season), 54% reported that they received the flu shot, and 55% said they received the Tdap vaccine during pregnancy.

The authors also found that pregnant women ages 15-44 accounted for 24-34% of flu-related hospitalizations per season, though data shows that only 9% of U.S. women in that age group are pregnant at any given time each year, the authors said. They added that maternal influenza vaccine reduced a pregnant woman's risk of flu-related hospitalization by 40%, and reduced the risk of hospitalization among infants younger than age 6 months by an average of 72%.

Likewise, the authors said that Tdap vaccine in the third trimester is 78% effective at preventing cases of pertussis and 91% effective in preventing pertussis among infants younger than age 6 months.

"Flu shots have been given to millions of pregnant women over the years [and] Tdap vaccine does not put pregnant women at risk for complications like low birth weight or preterm delivery," Schuchat said. "It's been proven repeatedly that these vaccinations are safe for women and their developing babies."