Progress of Cocooning Programs in Nevada and across the United States

Background:
Outbreaks of pertussis continue in the United States. Research has shown that family members and close contacts are the key vectors for newborns and infants less than one year of age. While adolescents and adults usually experience pertussis without serious sequelae, there are high morbidity and mortality rates in the infants they infect. This reality has led many hospitals to create proactive programs to "Cocoon" newborns and infants against pertussis. The ACIP recommendations for postpartum immunization of new parents with Tdap, has assisted in increasing these programs. Including influenza vaccine is an additional benefit of some “Cocooning” programs. Information on the variations in form, function and the impact of "Cocooning" may give more hospitals, health departments and immunization coalitions the information and encouragement they need to collaborate and begin “Cocooning” programs of their own.

Setting:
815-bed hospital in the Northwest United States with a delivery rate of 4,800 babies each year and 5 other hospitals of varying sizes in Nevada and across the United States.

Population:
Family members and healthcare workers who have direct contact with newborns and infants less than one year of age are encouraged to participate in "Cocooning".

Project Description:
Update on numbers and percentages of family members being "Cocooned" in the first hospital-wide program and 5 other hospitals across the United States. Suggestions will be provided on options for funding, education, process flow and maintaining staff commitment.

Results/Lessons Learned:
In the past 28 months, more than 14,000 doses of Tdap and 5,000 doses of influenza vaccine have been provided without charge to family members and health care workers in close contact with newborns and infants at the primary hospital. We are documenting some of the barriers to parents accepting immunizations and finding ways to overcome them. We hope to encourage and support other hospitals in protecting their infants against pertussis and influenza.