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Tdap coverage in a military beneficiary population: room for improvement.

Publication Status: Published

Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)

Sponsoring Office: Walter Reed National Military Medical Center

Congressionally Mandated: No

Funding Source: Defense Health Agency (formerly TRICARE Management Activity)

Release Date/Publication: October 01, 2013

Principle Investigator Status: Government

Primary DoD Data Source: Other

Secondary DoD Data Source:


Pertussis has had a resurgence in recent years. Women of child-bearing age and adults with infant contact are important reservoirs of infection because of waning immunity. Recent infant deaths and outbreaks led to new tetanus, diphtheria, and acellular pertussis (Tdap) vaccine recommendations, but vaccination rates remain low. A performance improvement project was started at Walter Reed Army Medical Center to target women of child-bearing age. Women treated in Gynecology had their electronic medical record screened for Tdap during their vital signs assessment. Those eligible for vaccination were directed to the Immunization Clinic. The intervention was considered successful if the patient received the vaccine within 30 days of the visit. Data were compiled on vaccination rates 1 month before and 1 and 3 months after the start of the performance improvement project. Only 13.9% of all patients had a documented Tdap at any time. During the first month following the intervention, vaccination rates within 30 days of the appointment increased from 0.38% to 6.5% (p < 0.005). The effect waned at 3 months following intervention, with only 1.1% of patients vaccinated within 30 days of the appointment. Overall vaccination rates remain low, and future studies should focus on barriers to vaccination to prevent morbidity and mortality.


Lam ST, George S, Dunlow S, Nelson M, Hartzell JD. Tdap coverage in a military beneficiary population: room for improvement. Mil Med. 2013 Oct;178(10):1133-6.

Last Updated: February 21, 2019

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