Cocooning: a concept to protect young children from infectious diseases
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Published on: September 6, 2019
Alexandra P Grizas1, Deepa Camenga, Marietta Vázquez
1Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA.
Insights
Cocooning infants against pertussis and influenza is crucial due to rising infection rates. However, low vaccine uptake and implementation barriers hinder this strategy
Area of Science:
- Pediatric infectious diseases
- Vaccinology
- Public health strategies
Background:
- Infant infections, particularly pertussis and influenza, are increasing, mirroring pre-vaccine eras.
- Cocooning involves vaccinating close contacts to protect infants.
- This strategy is being explored for both pertussis and influenza.
Purpose of the Study:
- To review the cocooning strategy for infant protection against pertussis and influenza.
- To identify barriers and facilitators for implementing cocooning.
- To discuss the current status and future directions of cocooning.
Main Methods:
- Literature review of cocooning strategies for pertussis and influenza.
- Analysis of vaccine uptake data among close infant contacts.
- Examination of individual and system-level factors affecting implementation.
Main Results:
- Pertussis and influenza cause significant infant hospitalizations.
- Vaccine uptake (Tdap and influenza) is low among those in close contact with infants.
- Widespread cocooning implementation faces individual and system-level challenges, despite high general vaccine acceptance.
Conclusions:
- The cocooning strategy requires further characterization and improvement.
- Longitudinal studies are needed to evaluate cocooning's effectiveness.
- Successful implementation depends on healthcare provider advocacy, patient education, policy enforcement, and cost-effective programs.
Purpose Of Review:
Despite focused efforts aimed at preventing infectious diseases among infants, recent years have seen a surge of infections among this population, particularly in pertussis, reminiscent of the 1940s prevaccine era. Given these trends, this review serves to discuss cocooning for infants against pertussis and its more recent application in influenza, and the barriers to and facilitators of this important strategy.
Recent Findings:
Infection with pertussis and influenza remains a significant cause of hospitalization among infants aged less than 1 year. Simultaneously, uptake of both tetanus, diphtheria, and acellular pertussis (Tdap) and influenza vaccines is very low among adults reporting close contact with an infant. To date, widespread implementation of cocooning has been thwarted by both individual-level and system-level issues, although general acceptance of vaccination is high in settings in which cocooning is encouraged.
Summary:
Better characterization and improvement of the cocooning strategy are necessary. Additionally, longitudinal research evaluating the effectiveness of cocooning against pertussis and influenza is essential. Ultimately, the effectiveness of cocooning to produce sustained control of infections will be dependent on healthcare provider advocacy, patient education, implementation and enforcement of policies, and the development of cost-effective programs.
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