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Acceptance of a post-partum influenza vaccination (cocooning) strategy for neonates in Greece
Helena C Maltezou1, Kleopatra Kalogriopoulou, Vasileios Pergialiotis
1Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece. helen-maltezou@ath.forthnet.gr
Insights
Influenza vaccination of household contacts (cocooning) is feasible in maternity settings. Maternal vaccination significantly increased paternal vaccination rates, highlighting the strategy
Area of Science:
- Public Health
- Vaccinology
- Epidemiology
Background:
- Infants are highly susceptible to severe influenza illness and complications.
- The cocooning strategy aims to protect infants by vaccinating their close contacts.
Purpose of the Study:
- To assess the feasibility and acceptance of an influenza vaccination (cocooning) strategy among household contacts of newborns.
- To identify factors associated with vaccination uptake in mothers and fathers.
Main Methods:
- A study was conducted in Athens involving 224 mothers and 242 neonates.
- Vaccination rates were recorded for mothers, fathers, and other household contacts.
- Logistic regression analysis identified factors influencing maternal vaccination.
Main Results:
- Maternal influenza vaccination rate was 73.7%; paternal rate was 55.8%.
- Factors associated with higher maternal vaccination included Roma origin, immigrant status, low birth weight neonates, and larger family size.
- Fathers whose partners were vaccinated had a six-fold higher vaccination rate.
- Complete cocoon vaccination was achieved in 22.7% of families.
- Primary reasons for refusal were "I do not want the vaccine" and "I am not at risk."
Conclusions:
- Influenza cocooning vaccination is feasible in maternity settings.
- Maternal vaccination positively influences paternal uptake, suggesting a potential for improved infant protection.
- Addressing parental misconceptions and barriers is crucial for enhancing vaccination coverage.
Abstract:
Young infants are at increased risk for influenza-associated serious illness, onset of complications, utilization of health-care services, and hospitalization. We investigated the feasibility and acceptance of an influenza vaccination (cocooning) strategy by household contacts implemented in a maternity hospital and the neonatal unit of a pediatric hospital in Athens. A total of 224 mothers (mean age: 30.2 years) who gave birth to 242 neonates were studied. Of them, 165 (73.7%) mothers were vaccinated. Multiple logistic regression revealed that statistically significant factors associated with increased vaccination rates among mothers were: being of Roma origin (p-value=0.002), being an immigrant (p-value=0.025), giving birth to a neonate with birth weight <2500g (p-value=0.012), and residing in a family with ≥4 family members (p-value=0.017). Of the 224 fathers, 125 (55.8%) received the influenza vaccine. Fathers of neonates whose mothers were vaccinated had 6-fold higher vaccination rates compared to fathers of neonates whose mothers refused vaccination (p-value<0.001). Overall, influenza vaccine was administered to 348 (46.9%) of a total of 742 household contacts of the 242 neonates. Upon entering the 2011-2012 influenza season, 51 (22.7%) of 224 families had all household contacts vaccinated against influenza (complete cocoon). Among parents, the statement "I do not want to receive the vaccine" was the prevalent reason for declining influenza vaccination, followed by the misconception "I am not at risk for contacting influenza" (41.1% and 38.2%, respectively).
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