Free vaccine programs to cocoon high-risk infants and children against influenza and pertussis
ABSTRACT An adult immunization strategy called "cocooning" is a relatively new concept, referring to immunizing close contacts of infants and high-risk children, thereby limiting pathogen exposure. This report explores the adoption of free vaccine programs in US children's hospitals and shares our own institutions' experiences in implementing free vaccine programs for close contacts of our patients.
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ABSTRACT: This article reviews the evidence base on the social and psychological factors that facilitate or hinder vaccination among adults. The authors categorized these factors into eight themes: social influence, disease-related factors, vaccine-related factors, habit, general attitudes toward health and vaccines, awareness and knowledge, practical barriers and motivators and altruism. Although there were many commonalities between both settings, the authors also indentifiedimportant differences. A better understanding of social and psychological aspects of vaccination across contexts and vaccines remains a priority.Expert Review of Vaccines 08/2013; 12(8). DOI:10.1586/14760584.2013.814841 · 4.22 Impact Factor
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ABSTRACT: Background. Influenza is associated with an increased risk for serious illness, hospitalization and mortality in infants <6 months. However, influenza vaccines are not licensed for administration in this age-group. The study evaluated the effectiveness of post-partum influenza vaccination of mothers and household members in infants. Methods. The influenza vaccine was offered to mothers and household members of neonates born or hospitalized in 3 hospitals prior to the 2012-2013 season. Mothers were contacted every 2 weeks during the influenza season and data regarding the onset of fever and/or respiratory symptoms in infants, health-care seeking, hospitalization, and administration of antibiotics were collected. Results. The study group consisted of 553 mothers who delivered 573 neonates. The influenza vaccine was administered to 841 (45.6%) of 1844 household contacts. Vaccination coverage rates ranged between 41.9% for neonates siblings and 49% for mothers. 530 infants were analyzed for vaccine effectiveness. For outcomes in the infant, post-partum maternal vaccination had 37.7% effectiveness against acute respiratory illness (ARI), 50.3% against a febrile episode, 53.5% against influenza-like illness (ILI), 41.8% against related health-care seeking, and 45.4% against administration of antibiotics. Multiple logistic regression analyses showed that maternal influenza vaccination was significantly associated with a decreased probability for febrile episodes, ARIs, and/or ILIs in infants, related health-care seeking, and/or administration of antibiotics during the influenza season. Vaccination of other household contacts had no impact. Conclusions. Maternal post-partum vaccination against influenza was associated with a significant reduction of influenza-related morbidity, health-care seeking, and antibiotic prescription in infants during the influenza season.Clinical Infectious Diseases 09/2013; DOI:10.1093/cid/cit599 · 9.42 Impact Factor
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ABSTRACT: Parental immunization ("cocooning") is a potentially effective strategy to protect neonates against Bordetella pertussis. The objective of this study was to evaluate three approaches to parental immunization: (1) current practice (single dTap dose to adolescents, one additional dose recommended in adults); (2) promotion of vaccination in the maternity ward, with vaccine offered in the community; and (3) promotion and administration of vaccine in the maternity ward. We conducted a two-phase study of postpartum women in a tertiary care obstetric-pediatric hospital in Montreal, Canada. In Phase I, mothers completed a standardized questionnaire regarding pertussis knowledge, attitudes and immunization status. Interviews provided information on cocooning and pertussis vaccination, and invited parents to receive the vaccine in the community. In phase II, information was provided (no questionnaire) with vaccination offered in the maternity ward before discharge. Phase I included 101 participants; Phase II, 244. Baseline knowledge on infant disease severity and adult vaccine recommendations was poor. Only 6% of women were considered protected. In Phase I, 56.3% and 62.5% of eligible mothers and fathers, respectively, were willing to receive the vaccine; only 5.4% and 8.7% were immunized in the community. In Phase II, 53.1% and 62.6% of mothers and fathers, respectively, would accept vaccination; 46.9% of mothers and 60.5% of fathers were immunized onsite (p<0.01). Offering dTap vaccine in the maternity ward is an effective approach to promote cocooning and increase vaccine uptake. The generalizability and cost effectiveness of this strategy should be investigated further.Vaccine 10/2013; 31(51). DOI:10.1016/j.vaccine.2013.09.043 · 3.49 Impact Factor