Effectiveness of parental cocooning as a vaccination strategy to prevent pertussis infection in infants: A case-control study |
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Affiliation: | 1. State Government Department of Health and Human Services, 50 Lonsdale Street, Melbourne, Victoria, Australia;2. Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia;3. School of Public Health, The University of Queensland, Brisbane, Queensland, Australia;4. UQ Child Health Research Centre, School of Medicine, The University of Queensland, Brisbane, Queensland, Australia;1. Canadian Center for Vaccinology, Dalhousie University, IWK Health Centre, and the Nova Scotia Health Authority, Halifax, Nova Scotia, Canada;2. School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada;3. Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada;4. School of Nursing, St. Francis Xavier University, Antigonish, Nova Scotia, Canada;5. Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada;6. Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada;7. Department of Microbiology & Immunology, Dalhousie University, Halifax, Nova Scotia, Canada;1. Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA;2. Department of Microbiology, Kabul University of Medical Science, Jamal Mina, 3rd District, Next to Ali Abad Teaching Hospital, Kabul, Afghanistan;3. Department of Internal Medicine, Division of Infectious Diseases, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA;1. School of Public Health and Community Medicine, UNSW, Sydney, NSW, Australia;2. The National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Children’s Hospital at Westmead and University of Sydney, Sydney, NSW, Australia;3. National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Acton, ACT, Australia;4. The Sax Institute, Sydney, NSW, Australia;5. Kirby Institute, UNSW, Sydney, NSW, Australia;1. Centre for the Evaluation of Vaccination, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium;2. Agency for Care and Health, Infectious Disease Control and Vaccination, Brussels, Belgium;1. Department of Neurodevelopment and Disability, The Royal Children’s Hospital, Melbourne, Australia;2. The Department of Paediatrics, The University of Melbourne, Melbourne, Australia;3. Developmental Disability and Rehabilitation Research Group, Murdoch Children’s Research Institute, Melbourne, Australia;4. Department of Haematology, The Royal Children’s Hospital, Melbourne, Australia;5. Nursing Research, The Royal Children’s Hospital, Melbourne, Australia;6. Clinical Haematology Research Group, Murdoch Children’s Research Institute, Australia;7. The Department of Nursing, The University of Melbourne, Melbourne, Australia;8. Clinical Learning and Development Unit, Bendigo Health, Victoria, Australia;9. Department of General Medicine, The Royal Children’s Hospital, Melbourne, Australia;10. Vaccine and Immunisation Research Group, Murdoch Children’s Research Institute, Melbourne, Australia;11. The School of Population Health, The University of Melbourne, Melbourne, Australia |
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Abstract: | BackgroundDuring a pertussis epidemic in 2009, the Department of Health, Victoria, Australia, implemented a cocoon program offering parents of new babies a funded-dose of pertussis-containing vaccine. We assessed vaccine effectiveness (VE) of the program in reducing pertussis infection in infants.MethodsUsing a matched case-control design, infants aged <12 months that were notified with pertussis between 1 January 2010 and 31 December 2011, and born during the time that the cocoon program was in place, were identified. Controls were matched by area of residence and date of birth. Telephone interviews we conducted to ascertain parents’ vaccination status, and if vaccinated, timing of vaccination receipt relative to the birth of their baby. Odds ratios (ORs) were calculated for the association between vaccination and pertussis infection, with VE calculated as (1 – OR) × 100%.ResultsThe study recruited 215 cases and 240 controls (response rates 67% and 25% of eligible participants, respectively). Vaccination of both parents after delivery of the infant and ≥28 days prior to illness onset reduced pertussis infection by 77% (Vaccine Effectiveness [VE] = 77% (confidence interval [95% CI], 18–93%). After adjusting for maternal education, presence of a sibling within the household, and the infants’ primary course vaccination status, the adjusted VE was 64% (95% CI, −58–92%).ConclusionsAlthough not reaching statistical significance, our results demonstrated that cocoon immunisation – where both parents are vaccinated in the post-partum period – may offer some protection again infant pertussis infection. Cocoon immunisation could be considered in circumstances where antenatal vaccination of the mother has not occurred. |
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Keywords: | Pertussis Cocoon Immunization Vaccine Vaccination Infant |
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