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Factors Affecting the Implementation and Acceptance of the Cocoon Strategy in the NICU in a Tertiary Center in
Şeyma Karatekin1,2, Selda Hançerli Törün3, Ebru Şenol2
1Department of Child Health and Disease, Faculty of Medicine, Samsun University, Samsun 55080, Türkiye.
Insights
The cocoon strategy for pertussis (whooping cough) vaccination is difficult for mothers to implement. Improving vaccine access, cost, and availability could increase Tdap vaccination rates in infants
Area of Science:
- Public Health
- Immunization
- Pediatrics
Background:
- Pertussis (whooping cough) poses significant risks to infant health, necessitating protective measures.
- The cocoon strategy, involving Tdap vaccination of close contacts, is recommended to shield infants.
Purpose of the Study:
- To assess the feasibility of the cocoon strategy for pertussis prevention.
- To identify barriers influencing Tdap vaccination uptake among mothers of hospitalized infants.
Main Methods:
- A three-stage study involving questionnaires on pertussis knowledge, information dissemination on the cocoon strategy, and follow-up on Tdap vaccination status.
- Participants included mothers of infants in a neonatal intensive care unit.
Main Results:
- A significant knowledge gap regarding pertussis and its vaccine was observed (68% incorrect answers).
- Post-information, only 35% of mothers intended to vaccinate, but only 2% actually received the Tdap vaccine.
- Key barriers included lack of time (24%) and vaccination cost (23%).
Conclusions:
- The cocoon strategy faces challenges in practical implementation due to low maternal vaccination rates.
- Facilitating vaccine cost, availability, and accessibility is crucial for enhancing Tdap vaccination coverage and infant protection.
Abstract:
Pertussis is an important cause of mortality and morbidity in infancy. It is recommended that close contacts of the baby be vaccinated with Tdap, and this practice is called the cocoon strategy. This study aimed to investigate the applicability of the cocoon strategy and to determine the factors affecting the process. Mothers of babies who were hospitalized in the neonatal intensive care unit were included in the study. In the first stage, a face-to-face questionnaire was given to the mothers to measure their level of knowledge about whooping cough and its vaccine. In the second stage, written and verbal information about the cocoon strategy was given, and then vaccination intentions for Tdap were learned. In the third stage, all mothers were contacted 3 weeks after and asked whether they had received a Tdap vaccination and why. Of these mothers, 68% could not answer any questions about pertussis disease and vaccines correctly. After the information, 35% (n = 78) of the mothers stated that they were considering getting vaccinated, while only 2% (n = 5) of the mothers were able to get the Tdap vaccine. The most important reasons for not getting vaccinated were a lack of time (24%) and the cost of vaccination (23%). It is predicted that Tdap vaccination rates may increase if the cost of vaccine, availability of vaccine, and the access of mothers to the vaccine application are facilitated.
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