Marchal Clarisse, Belhassen Manon, Guiso Nicole, Jacoud Flore, Cohen Robert, Le Pannerer Marie, Verdier Régis
PELyon (Pharmaco Epidemiology Lyon), Lyon, France.
Independent Expert, Paris, France.
Front Pediatr. 2022 Oct 18;10:988674. doi: 10.3389/fped.2022.988674. eCollection 2022.
The "cocooning" strategy was introduced in 2004 to protect infants too young to be vaccinated against pertussis, by immunizing their parents and close relatives. The study objective was to assess its implementation 12 years after its introduction by estimating the pertussis vaccination coverage rates (VCR) among parents of newborns.
Pertussis VCR were estimated among all women who gave birth and men who took paternity leave, in 2016 or 2017, from a 1/97th random sample of French claims data. Two distinct study periods were defined based on current recommendations for the cocooning strategy: the "common practice" and the "parental project" periods.
In 2016, the pertussis VCR of women having given birth and men having taken paternity leave was 47.2 and 47.1%, respectively (46.1 and 45.6% in 2017, respectively). About one quarter of vaccinations were performed during the "parental project" period, with the vaccine most frequently reimbursed during the month of childbirth for women (57.1% in 2016 and 49.4% in 2017) and before or during the month the paternity leave began for men (about 78% in both 2016 and 2017). General practitioners were the main prescribers in private practice, even during the "parental project" period.
To optimize the protection for infants, the main objective of the cocooning strategy, pertussis immunization coverage of adults and seniors needs to be improved. Moreover, cocooning vaccination linked to a parental project needs to be performed earlier, during pregnancy (for those around the mother) or in immediate (e.g., during the maternity stay).
“围裹式”策略于2004年推出，通过为婴儿父母及近亲接种疫苗来保护太小而无法接种百日咳疫苗的婴儿。本研究的目的是通过估计新生儿父母的百日咳疫苗接种覆盖率（VCR），评估该策略推出12年后的实施情况。
从法国索赔数据的1/97随机样本中，估计2016年或2017年所有分娩妇女和休陪产假男子的百日咳VCR。根据当前围裹式策略的建议定义了两个不同的研究时期：“常规做法”和“父母计划”时期。
2016年，分娩妇女和休陪产假男子的百日咳VCR分别为47.2%和47.1%（2017年分别为46.1%和45.6%）。约四分之一的疫苗接种在“父母计划”时期进行，女性在分娩当月最常报销疫苗费用（2016年为57.1%，2017年为49.4%），男性在陪产假开始前或当月进行报销（2016年和2017年约为78%）。全科医生是私人执业中的主要开方者，即使在“父母计划”时期也是如此。
为优化对婴儿的保护（围裹式策略的主要目标），需要提高成人和老年人的百日咳免疫覆盖率。此外，与父母计划相关的围裹式疫苗接种需要更早进行，在孕期（针对母亲周围的人）或即刻进行（例如，在住院期间）。
