Administration of Tetanus, Diphtheria, and Acellular Pertussis Vaccine to Parents of High-Risk Infants in the Neonatal Intensive Care Unit

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Administration of Tetanus, Diphtheria, and Acellular Pertussis Vaccine to

Parents of High-Risk Infants in the Neonatal Intensive Care Unit

M. Dylag and Shetal I. Shah

Pediatrics. 2008; 122(3): p. e550-e555

http://pediatrics.aappublications.org/cgi/content/abstract/122/3/e550?ct

Division of Neonatology, Department of

Pediatrics, School of Medicine, State University

of New York, Stony Brook, New York

OBJECTIVE. Tetanus, diphtheria, and acellular

pertussis vaccination is recommended for adults

who are in contact with infants who are younger

than 12 months and in the NICU. The objective of

this study was to determine the feasibility of

tetanus, diphtheria, and acellular pertussis

vaccine administration to parents in a tertiary

care, level III NICU and to measure its effect on

vaccination rates among parents of this high-risk population.

METHODS. For a 4-month period from July to

October 2007, all parents of admitted patients

were informed of the risks and benefits of

tetanus, diphtheria, and acellular pertussis

vaccine by placing an information letter at their

infant's bedside. All staff were educated about

the dangers of pertussis infection and instructed

to reinforce the need to obtain vaccination.

Immunization was available for 20 hours per day

at no cost. Student's t tests were used for data analysis.

RESULTS. During the study period, 352 children

(598 eligible parents) were admitted to the NICU

at gestational ages ranging from 23 to 42 weeks,

and 495 (82.8%) parents were offered the vaccine.

Overall vaccination rate was 86.9% (430 parents)

of the screened population. Fifty-five (11.1%)

parents in the screened cohort refused

vaccination, predominately citing pertussis as an

insignificant health threat or disbelief in

vaccination. There were no differences in

vaccination rate on the basis of parental age. No

allergic reactions to vaccination were observed.

The 54 infants whose parents were not offered

vaccine had a significantly shorter length of

stay, higher birth weight, and higher gestational

age than parents who were offered vaccine.

CONCLUSIONS. Administration of tetanus,

diphtheria, and acellular pertussis vaccine in

the NICU is an effective means of increasing

vaccination rates of parents of this population.

Logistic barriers persist when implementing this

program for infants with a short (<3-day) length of stay.

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Key Words: pertussis • immunization • neonatal intensive care • public health

Abbreviations: TdaP­tetanus, diphtheria, and acellular pertussis