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Objectives: We evaluated differences in vaccination rates of patients of teaching and private practices, and explored the rate of vaccine hesitancy in pregnant women. Methods: This was a cross-sectional study of a convenience sample of recently delivered women. Women completed a survey, which included a question about whether they received the influenza and/or Tdap vaccine, and a vaccine hesitancy scale for both influenza and Tdap vaccines. We also reviewed prenatal records to confirm vaccine administration and collected demographic data. Patients who received care on the teaching service (care by residents supervised by faculty) were compared with those who received care from 26 private practitioners in nine groups. The primary outcome was rate of vaccination. Fisher's exact test was performed to compare groups. Results: Of the 231 women approached, 208 (90.0%) agreed to participate. Of the 208 participants, 70 (33.7%) had prenatal care with a teaching practice, and 138 (66.3%) with a private practice. Patients of teaching practices had a higher influenza and Tdap vaccination rate compared with patients of private practices (Influenza: 70% versus 54.3%, p = 0.036; Tdap: 77.1% versus 58.4%, p = 0.009). Among the entire cohort, 55.3% had some degree of vaccine hesitancy. This did not differ between teaching and private practices (54.3% versus 55.8%, p = 0.883). Conclusions: In spite of similar prevalence of vaccine hesitancy, pregnant women cared for in teaching practices had higher vaccination rates than those cared for in private practices. Significance: What is Already Known on this Subject? Prior studies have assessed individual patient characteristics as predictors of influenza and tetanus, diphtheria, and pertussis (Tdap) vaccination in pregnancy, but little is published on the role of provider type. What this Study Adds? Teaching practices had higher vaccination rates in pregnancy than private practices despite similar prevalence of vaccine hesitancy between groups. Areas of future research should focus on incorporating evidence-based strategies in practices, particularly private practices, to improve vaccination rates in pregnancy. [ABSTRACT FROM AUTHOR]

Seasonal influenza continues to impose a substantial healthcare and economic burden in the United States each year. This study assessed influenza vaccination rates among the uninsured population, determined the need for free flu vaccines, and analyzed associations of vaccination status with access, beliefs, and sociodemographic factors. Stony Brook Outreach and Medical Education (SB HOME) free clinic offers free flu vaccinations to uninsured patients over the age of 18 living in Suffolk County, New York. All patients visiting SB HOME between October 2018 and February 2019 were offered a 10-min anonymous survey assessing demographic characteristics, self-evaluation of health status, vaccination status during the 2017–2018 and 2018–2019 flu seasons, willingness to obtain a free flu vaccine, and beliefs and barriers surrounding flu vaccines. Analysis consisted of descriptive statistics, paired t tests, and χ2 tests using a significance threshold of p < 0.05. A total of 102 participants were surveyed, 80% of whom identified as Hispanic/Latino. The majority of participants expressed positive attitudes towards the influenza vaccine. Despite these positive attitudes, 72% reported not receiving the influenza vaccination during the 2017–2018 flu season, the commonly cited reasons being fear of getting sick from the flu vaccine, high cost, and not knowing where to get the vaccine. During the 2018–2019 flu season 60% of participants elected to receive a free flu shot at SB HOME, and participants with positive attitudes towards flu vaccines were more likely to accept the vaccine when offered at no cost. Fear of getting sick from the flu vaccine remained the most common reason for participants declining a free flu vaccine. Only 17% of participants would seek vaccination at the market price of $30, compared to the 76% who would if the vaccine was offered for free. Our study highlights the need for convenient and affordable access to the flu vaccine among uninsured populations, who despite recognizing the benefits of receiving the flu vaccine are unable to overcome certain barriers. Elucidating and targeting barriers specific to uninsured populations at the local community level may improve public health strategies centered on increasing vaccination rates. [ABSTRACT FROM AUTHOR]