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Cocoon Vaccination Among Mothers of Very Preterm Infants

Deepa James1, Anju Joy1, Femitha Pournami2

  • 1Department of Neonatology, KIMS Health, Trivandrum, Kerala, 695029, India.

Indian Pediatrics
|July 25, 2025
PubMed

Insights

Cocoon vaccination coverage was low among mothers of very preterm infants, with less than 50% receiving all recommended vaccines. This highlights a need for improved immunization strategies for close contacts of high-risk infants.

Area of Science:

  • Neonatal care
  • Immunology
  • Public Health

Background:

  • Preterm infants face increased risk of communicable diseases after hospital discharge.
  • The cocoon strategy, which involves immunizing close contacts, aims to protect vulnerable infants from infections.
  • Assessing vaccine uptake among mothers is crucial for evaluating the effectiveness of the cocoon strategy.

Purpose of the Study:

  • To evaluate the coverage of cocoon vaccines (Tdap, influenza, varicella) among mothers of very preterm infants.
  • To identify gaps in vaccination compliance within the maternal population.

Main Methods:

  • Retrospective analysis of vaccination records for mothers of infants born before 30 weeks gestation.
  • Inclusion of tetanus, diphtheria, and acellular pertussis (Tdap), influenza, and varicella vaccines in the assessment.
  • Evaluation of vaccine administration during antenatal or postnatal periods.

Main Results:

  • Only 47.2% of mothers received all three recommended cocoon vaccines.
  • Influenza and Tdap vaccine uptake was 64.1% and 48.5%, respectively.
  • Cocoon vaccine coverage among fathers was also low, at 49.2%.

Conclusions:

  • Maternal compliance with the cocoon vaccination protocol is below 50%.
  • Significant improvements are needed in vaccination coverage among close contacts of high-risk infants.
  • Enhanced strategies are required to ensure adequate protection for vulnerable preterm survivors.
Abstract

Keywords:
CocooningHerd immunityImmunizationVaccine-preventable disease

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