Improving adherence rates to a cocooning program: a pilot experience in Italy

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Vaccinology

Background:

• Pertussis (whooping cough) poses a significant risk to newborn infants due to their incomplete vaccination status.
• The cocoon strategy aims to reduce infant pertussis transmission by immunizing their close contacts, including household members.
• Implementing cocooning programs faces programmatic and logistical challenges in real-world healthcare settings.

Purpose of the Study:

• To evaluate the adherence and acceptance rates of a pertussis cocoon strategy among newborn contacts in an Italian healthcare setting.
• To identify factors influencing the successful implementation of the cocoon strategy for pertussis prevention in infants.

Main Methods:

• A one-year pilot project was conducted at ASL Napoli 1 Centro, offering free dTpa booster vaccinations to parents and household contacts of newborns.
• Initial implementation phase showed low uptake (2.6%).
• Communication strategies were enhanced with information leaflets, increased healthcare provider (HCP) involvement, and focused patient interaction during maternity ward visits.

Main Results:

• Following communication improvements, dTpa booster uptake among contacted new mothers increased dramatically to 78.8% (601 out of 762).
• The enhanced approach demonstrated a significant improvement in adherence to the cocoon strategy.
• This study represents the first documentation of successful pertussis cocooning implementation in Italy.

Conclusions:

• High acceptance rates for the pertussis cocoon strategy are achievable with effective communication tools and dedicated, skilled healthcare providers.
• Optimizing communication and resource allocation is crucial for the successful programmatic implementation of infant pertussis prevention strategies.
• The findings support the broader adoption of the cocoon strategy to protect vulnerable newborns from pertussis.