NEW YORK (Reuters Health) – New research suggests that the neonatal intensive care unit (NICU) is a good setting for administering the tetanus, diphtheria, and acellular pertussis vaccine (TdaP) to parents of high-risk infants.

The US Centers for Disease Control and Prevention recommends 1 dose of TdaP for previously unimmunized adults who will have close contact with NICU infants younger than 12 months, according to the report in the September issue of Pediatrics.

In the current study, Dr. Shetal I. Shah and Andrew M. Dylag, from the State University of New York, Stony Brook, assessed the feasibility of administering TdaP to parents of high-risk infants in a tertiary care, level III NICU.

From July to October 2007, parents of NICU-admitted infants were presented with an information letter at their child’s bedside explaining the risks and benefits of TdaP vaccination. The risks of pertussis infection were reinforced with NICU staff and the importance of obtaining vaccination from parents was emphasized. Vaccination was provided free of charge, 20 hours per day.

A total of 352 children between 23 and 42 weeks’ gestational age were admitted to the NICU during the study period. Of 598 eligible parents, 495 (82.8%) were offered TdaP.

The researchers note that at baseline less than 2% of parents had received TdaP.

Overall, 430 parents received TdaP, yielding a vaccination rate of 86.9% in the screened population. Fifty-five parents (11.1%) refused vaccination, usually because they believed pertussis was not an important health threat or because of disbelief in the vaccine. In 10 parents (2.0%), vaccination was medically contraindicated.

Parental age was not a determinant of vaccination, the report indicates. Shorter length of stay, higher birth weight, and higher gestational age were all correlates of not being offered the vaccine.

TdaP vaccination was well tolerated and no allergic reactions were noted, the findings show.

“Additional multicenter trials are required to determine whether this immunization rate is reproducible in other NICUs and sustainable for periods greater than the 4-month trial period,” the authors conclude.

Reference:
Pediatrics 2008;122:e550-e555.