Nation's First 'Cocoon Strategy' Vaccination Program Delivers 10,000th Immunization

Physicians from the Center for Vaccine Awareness and Research at Texas Children's Hospital reported that 10,000 Tdap immunizations have been administered to immediate family members of newborn babies at part of the nation's first and only major "cocoon strategy" vaccination program. 

Designed to protect infants from the life-threatening and highly contagious pertussis (whooping cough) infection, the program aims to vaccinate family members who come in close contact with the infant. 

Implemented at Harris County Hospital District's Ben Taub General Hospital, where the population is generally at higher risk for whooping cough, the cocoon strategy is recommended by the Centers for Disease Control and Prevention (CDC) as the only protection against whooping cough available to infants less than six months of age, too young to be protected by their childhood vaccines. More than 75 percent of young infants who contract whooping cough are infected by a member of their household.

Whooping cough cases in the U.S. rose 27 percent in 2008 to 13,200 cases, with 15 percent (2,048) occurring in Texas. Nationally 20 deaths were reported, four of which occurred in Texas, including one in Houston.  All fatalities were infants under six months of age.

"The program's acceptance by families has exceeded our expectations," said Dr. C. Mary Healy, director of Vaccinology and Maternal Immunization at the Center for Vaccine Awareness and Research at Texas Children's Hospital.

Since the program's launch in January 2008, Healy reports that 96 percent of women who delivered babies at Ben Taub General Hospital and did not report a contraindication to the vaccine were immunized. On average, two family members per newborn have received the vaccine and as many as 10 in one family have participated. Most family participants were vaccinated prior to the infant's discharge from the hospital.

The program team, which is a collaboration of doctors and medical staff from the Texas Children's Center for Vaccine Awareness and Research as well as the Departments of Obstetrics and Gynecology, Pediatrics, Neonatology, Nursing and Pharmacy at Ben Taub General Hospital, communicates with families in both English and Spanish to educate them about the benefits of the cocoon strategy.

"This innovative project is part of a joint wellness and prevention program," said Dr. Kenneth L. Mattox, chief of staff, Ben Taub General Hospital. "It demonstrates a very beneficial cooperative program among several healthcare delivery venues to protect our youngest patients."

While the public health benefits of the cocoon strategy are apparent, Healy noted that the program has not been widely implemented by other heathcare organizations because of the planning and infrastructure needed.

The program is made possible by financial grants from the Baylor Methodist Community Health Fund and Children's Health Fund of the Harris County Hospital District Foundation, as well as donated physician time and thousands of doses of donated Tdap vaccine.

Since implementing the cocoon strategy in a public hospital, Healy says she has been contacted by doctors, hospital administrators and other medical professionals from around the country seeking information on how to develop a similar program.