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Electronic health records (EHR) have been promoted to improve clinical care and reduce healthcare costs. To study the effects of an EHR-based alert for prenatal tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccination, investigators in Dallas compared immunization rates before and after installation of the alert. During the 13 months post-alert, 97% of 10,200 women receiving prenatal care were vaccinated; during the year before the alert's initiation (when Tdap vaccines were only offered postpartum), 48% of 10,600 mothers were vaccinated. Pertussis incidence among neonates born to mothers receiving prenatal care in this system declined from 13 to 7 cases per 10,000 deliveries, although the relative contributions…