Pertussis Cocooning: The Concept, Experiences and Lessons Learned
This report, published by KHI for the Immunize Kansas Kids coalition, examines ways to protect infants from Pertussis, commonly called whooping cough.
Pertussis is a highly contagious respiratory illness. Despite long-standing pertussis immunization programs and high rates of vaccination coverage in the United States, the disease has remained poorly controlled. It is particularly dangerous for infants under six months of age, who are too young to be immunized.
One approach to preventing Pertussis infection among infants has been to create a protected shield (a cocoon) around the child to minimize the risk of infection. This is done by ensuring that all adults and family members in close contact with the infant are immunized against pertussis. Implementation of pertussis cocooning, however, has proven to be challenging and the effectiveness of cocooning alone as a strategy for preventing infant infection has been called into question.
Experts now believe the best opportunity to protect infants from pertussis is to vaccinate women during each pregnancy. In December 2012, the Advisory Committee on Immunization Practices (ACIP) issued a provisional recommendation that Tdap vaccine be administered to all women during each pregnancy, preferably after 20 weeks of gestation.
Of course, ensuring that children and adolescents are fully immunized, and increasing the number of adults who have received Tdap immunization will also help to reduce the opportunities for infant exposure and infection.