Mothers accept tetanus, diphtheria, and acellular pertussis vaccine in pediatric office

A study conducted in a hospital-based clinic serving mostly low-income families shows that mothers and other infant caregivers generally accept free Tdap (tetanus, diphtheria, and acellular pertussis) vaccine when it is offered during an infant's 2-week well-child visit.

Participants in a pilot vaccine project included 102 adults (62 mothers and 40 caregivers; mean age, 30 years). Seventy percent of the nonmother caregivers were fathers. Most participants (54%) had Medicaid insurance, although 38% of caregivers and 15% of mothers had no insurance. In addition, 23% of caregivers and 8% of mothers reported having no routine medical care.

During the infant visit, pediatricians routinely asked all mothers and caregivers about their vaccine status and offered them a free Tdap vaccination; 69% accepted. Eight participants said that they had already received Tdap, and 24 refused the vaccination. Participants reported that the 68 infants they accompanied to the visits had a total of 152 adult household contacts, and 46% of those contacts also were vaccinated through this initiative.

Commentary

This is a great idea! Pediatricians immunizing parents and other caregivers would protect many young babies from both pertussis and influenza. However, adopting this practice would require getting over a number of hurdles, not the least of which would be arranging for payment for the vaccine and vaccine administration. The American Academy of Pediatrics Committees on Infectious Diseases and Practice and Ambulatory Medicine recently published a technical report on immunizing parents and family contacts in the pediatric office setting. For an up-to-date summary of this practice's benefits and barriers, see Lessin HR, et al. Pediatrics. 2012;129(1):e247-e253.

-Michael Burke, MD