The obstetrician-gynecologist's role in adult immunization.

Vaccine-preventable diseases (VPDs) account for significant morbidities and mortalities in the United States on an annual basis. Despite generally successful childhood vaccine programs, adults remain underimmunized against a variety of common VPDs. Lack of both physician and patient awareness contribute to this deficiency. All primary care providers, including obstetrician-gynecologists, must address this need in their office practices. Clear and authoritative adult vaccine recommendations are established and easily accessible by the clinician. Pregnancy is not an absolute contraindication to vaccine administration. In fact, certain vaccines are specifically indicated during pregnancy in the interest of the mother and her unborn child. Women frequently identify gynecologists as their sole providers of care, further emphasizing the need for attention to this health maintenance activity. New vaccine initiatives, in particular those focused on early newborn infectious conditions, sexually transmitted diseases, and cancer prevention, will likely place the obstetrician-gynecologist at the forefront of this important clinical issue.