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.

Key Words: pertussis • immunization • neonatal intensive care •

public health

Abbreviations: TdaP­tetanus, diphtheria, and acellular

pertussis