Dylag Andrew M, Shah Shetal I
Stony Brook University Medical Center, Health Sciences Center Tower, 11th Floor, 060, Stony Brook, NY 11794, USA.
Pediatrics. 2008 Sep;122(3):e550-5. doi: 10.1542/peds.2008-0813.
Tetanus, diphtheria, and acellular pertussis vaccination is recommended for adults who are in contact with infants who are younger than 12 months and in the NICU. The objective of this study was to determine the feasibility of tetanus, diphtheria, and acellular pertussis vaccine administration to parents in a tertiary care, level III NICU and to measure its effect on vaccination rates among parents of this high-risk population.
For a 4-month period from July to October 2007, all parents of admitted patients were informed of the risks and benefits of tetanus, diphtheria, and acellular pertussis vaccine by placing an information letter at their infant's bedside. All staff were educated about the dangers of pertussis infection and instructed to reinforce the need to obtain vaccination. Immunization was available for 20 hours per day at no cost. Student's t tests were used for data analysis.
During the study period, 352 children (598 eligible parents) were admitted to the NICU at gestational ages ranging from 23 to 42 weeks, and 495 (82.8%) parents were offered the vaccine. Overall vaccination rate was 86.9% (430 parents) of the screened population. Fifty-five (11.1%) parents in the screened cohort refused vaccination, predominately citing pertussis as an insignificant health threat or disbelief in vaccination. There were no differences in vaccination rate on the basis of parental age. No allergic reactions to vaccination were observed. The 54 infants whose parents were not offered vaccine had a significantly shorter length of stay, higher birth weight, and higher gestational age than parents who were offered vaccine.
Administration of tetanus, diphtheria, and acellular pertussis vaccine in the NICU is an effective means of increasing vaccination rates of parents of this population. Logistic barriers persist when implementing this program for infants with a short (<3-day) length of stay.
对于接触12个月以下婴儿及新生儿重症监护病房（NICU）患儿的成人，建议接种破伤风、白喉和无细胞百日咳疫苗。本研究的目的是确定在三级医疗水平III级NICU中，为患儿父母接种破伤风、白喉和无细胞百日咳疫苗的可行性，并评估其对这一高危人群父母疫苗接种率的影响。
在2007年7月至10月的4个月期间，通过在患儿床边放置信息信，向所有住院患儿的父母告知破伤风、白喉和无细胞百日咳疫苗的风险和益处。对所有工作人员进行百日咳感染危险性的教育，并指示他们强调接种疫苗的必要性。每天提供20小时的免费免疫接种服务。采用学生t检验进行数据分析。
在研究期间，352名儿童（598名符合条件的父母）入住NICU，胎龄为23至42周，495名（82.8%）父母被提供了疫苗。筛查人群的总体疫苗接种率为86.9%（430名父母）。筛查队列中有55名（11.1%）父母拒绝接种疫苗，主要理由是认为百日咳对健康威胁不大或不信任疫苗。疫苗接种率在父母年龄方面没有差异。未观察到疫苗接种的过敏反应。其父母未被提供疫苗的54名婴儿的住院时间明显短于被提供疫苗的父母的婴儿，出生体重更高，胎龄也更大。
在NICU接种破伤风、白喉和无细胞百日咳疫苗是提高该人群父母疫苗接种率的有效手段。对于住院时间短（<3天）的婴儿实施该计划时，仍存在后勤障碍。
