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PHR Article of the Week: Protecting Newborns by Immunizing Family Members in a Hospital-Based Vaccine Clinic: A Successful Tdap Cocooning Program During the 2010 California Pertussis Epidemic

In the latest issue of Public Health Reports, May/June 2014, the University of California and San Diego Health and Human Services members Dr. Elizabeth Rosenblum, Dr. Sarah McBane, Ms. Wendy Wang, and Dr. Mark Sawyer report on the successes of the Tdap Cocooning Program during the 2010 California Pertussis Epidemic. The program is used to protect newborns by immunizing family members in a hospital-based vaccine clinic.

Infants are at greatest risk for mortality from pertussis infection. Since 2005, the Advisory Committee on Immunization Practices has recommended a cocooning strategy of vaccinating all close contacts of infants with tetanus, diphtheria, and acellular pertussis (Tdap) vaccine to reduce the risk of transmitting pertussis. Difficulties in establishing a complete cocoon have been reported in the literature. We determined whether families of newborns could be fully immunized against pertussis, thereby providing a complete cocoon of protection.

The report shows that during the intervention period, 243 postpartum patients and 1,287 other family members of newborns were immunized, with 84.8 percent of all family members receiving Tdap vaccination. Seventy-six percent of households reported a complete cocoon. In the control group, 52.2 percent of all family members received Tdap vaccination, and 29.3 percent of households had a complete cocoon. In the control group, fewer family members completed Tdap vaccination in the larger households than in the smaller households (p=0.008). It can now be concluded that a cocooning strategy can be successfully implemented, such that the majority of newborns leave the hospital with their families fully immunized against pertussis.

This week’s PHR feature article, Protecting Newborns by Immunizing Family Members in a Hospital-Based Vaccine Clinic: A Successful Tdap Cocooning Program During the 2010 California Pertussis Epidemic,  will be open access through June 19. For full access to all current content, visit the Public Health Reports website to subscribe.