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


HOUSTON -(Feb. 1, 2010) - Physicians from the Center for VaccineAwareness and Researchat Texas Children's Hospital reported that 10,000 Tdap immunizations have nowbeen administered to the mothers and immediate family members of newborn babiesat Harris County Hospital District's Ben Taub GeneralHospital, where the patient population is generally at higher risk forpertussis infection.

Theimmunizations are part of one of the nation's only major "cocoon strategy"vaccination programs, designed to protect newborn infants from thelife-threatening and highly contagious pertussis infection, more commonly knownas whooping cough.

Nearly 75% ofinfants who contract whooping cough are infected by someone in their householdand nearly two-thirds of infected infants under 6 months are hospitalized.Immunity from the vaccine wanes after 5 to 10 years. In 2008, whooping coughcases in the U.S. rose 27% over the prior year to 13,200 cases, with 15%(2,048) in Texas. Nationally there were 20 deaths, 4 of which occurred inTexas, including one in Houston. All reported deaths were infants under 6months of age.

The cocoonstrategy is recommended by the Centers for Disease Control and Prevention (CDC)as the only protection against whooping cough available to infants less than 6months of age, too young to be protected by their childhood vaccines given at2, 4 and 6 months of age. The "cocoon" is created by vaccinating family memberswho will be in close contact with the infant so that the baby is surrounded bypeople who cannot spread the infection. The Texas Children's program wasimplemented in 2008.

"Theprogram's acceptance by families has exceeded our expectations," said Dr. C.Mary Healy, program leader and director of Vaccinology and MaternalImmunization at the Center for Vaccine Awareness and Research at TexasChildren's Hospital.

She reportsthat 96% of women who delivered babies at Ben Taub General Hospital and did notreport a contraindication to the vaccine were immunized. An average of 2 familymembers per newborn have received the vaccine through the program and as manyas 10 in a single family have participated. As recommended by the CDC, 91% ofthe immunized family members were vaccinated prior to the infant beingdischarged from the hospital.

Of those whoreceived Tdap through the program to date, 93% were of Hispanic ethnicity and11% were less than 20 years of age, both factors that place mothers at astatistically higher risk of acquiring whooping cough and passing the infectionto their young infant.

The programteam, which is a collaboration of doctors from the Texas Children's Center forVaccine Awareness and Research as well as the Departments of Obstetrics andGynecology, Pediatrics, Neonatology, Nursing and Pharmacy at Ben Taub GeneralHospital, communicates with families in both English and Spanish to educate themother and her family about the benefits of the cocoon strategy.

"Thisinnovative project is part of a joint wellness and prevention program," saidDr. Kenneth L. Mattox, chief of staff, Ben Taub General Hospital. "Itdemonstrates a very beneficial cooperative program among several healthcaredelivery venues to protect our youngest patients."

In order toachieve such high acceptance rates for the vaccine, Healy said that educatinghospital care givers and patient families is a key factor. In-service trainingabout pertussis for Ben Taub's staff raised awareness and advocacy for theprogram. This training helps hospital care givers in explaining the program andits benefits to postpartum mothers. Bilingual educational pamphlets aredistributed to families and Texas Children's cocoon strategy team members areavailable in person 5 days a week or by phone 24-hours a day to answer any questionsor concerns that arise.

While thepublic health benefits of the cocoon strategy are apparent, Healy noted thatthe program has not been widely implemented by other heath care organizationsbecause of the planning and infrastructure needed.

"The cooperationand support of Ben Taub General Hospital has been instrumental in making thisprogram such a success," said Healy. "Through our joint efforts, we havealready protected thousands of infants from a potentially deadly disease andhelped to stop the spread of pertussis in our community."

The cocoonstrategy vaccination program administered by Texas Children's Hospital is madepossible by financial grants from the Baylor Methodist Community Health Fund and Children's Health Fund of the Harris County HospitalDistrict Foundation,as well as donated physician time and thousands of doses of donated Tdapvaccine.

Since theimplementation of the cocoon strategy here in Houston, Healy has been contactedby doctors, hospital administrators and other medical professionals from aroundthe country seeking information on how to develop such a program. Mostrecently, she has consulted with physicians and public health officials fromWilliamson County, Texas, because the area is in the midst of a major pertussisoutbreak. Healy has been asked to present information on the cocoon strategyvaccine program to physicians statewide during an upcoming Texas Department ofHealth webinar. She will also make a presentation to the CDC later this year.

"It isimportant to share with other healthcare professionals what we have learnedfrom the implementation and ongoing operation of the cocoon strategy," said Dr.Carol Baker, executive director of the Center for Vaccine Awareness andResearch at Texas Children's Hospital. "Programs like this are at the heart ofour mission to research more effective vaccine delivery models."

About Texas Children’s Hospital

Texas Children’s Hospital, a not-for-profit health care organization, is committed to creating a healthier future for children and women throughout the global community by leading in patient care, education and research. Consistently ranked as the best children’s hospital in Texas, and among the top in the nation, Texas Children’s has garnered widespread recognition for its expertise and breakthroughs in pediatric and women’s health. The hospital includes the Jan and Dan Duncan Neurological Research Institute; the Feigin Center for pediatric research; Texas Children’s Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children’s Hospital West Campus, a community hospital in suburban West Houston; and Texas Children’s Hospital The Woodlands, a second community hospital planned to open in 2017. The organization also created the nation’s first HMO for children, has the largest pediatric primary care network in the country and a global health program that’s channeling care to children and women all over the world. Texas Children’s Hospital is affiliated with Baylor College of Medicine. For more information, go to www.texaschildrens.org. Get the latest news by visiting the online newsroom and Twitter at twitter.com/texaschildrens.