Should Pediatricians Be Vaccinating the Parents of Patients (eg, With Tdap and Flu Vaccines)?
SPECIAL ISSUE: FOCUS ON VACCINES
Two Opposing Views On Relevant Topics
PRO: Newborns and young infants represent the population most at risk for the burden of severe pertussis-related and influenza-related morbidity and mortality. The sources of these infections in infants are often unclear but are probably adolescents and adults (pertussis) and children and adults (influenza).1
Strategies to protect infants include indirect (primary and booster immunizations for siblings and parents) and direct (vaccination of infants soon after birth) prevention measures. Unfortunately, direct immunization against influenza is not possible until an infant is 6 months old; full protection is reached weeks after the second booster vaccination. For pertussis, full protection from immunization may not be reached until completion of the primary vaccine series, when the child is a toddler. Cocooning the infant by immunizing all potential contacts is probably the most effective indirect strategy to protect these young susceptible children from pertussis and influenza.
Successful indirect prevention measures have involved postpartum Tdap vaccination of mothers and administration of free influenza vaccine to family members in the neonatal ICU.2,3 A more comprehensive solution is to offer influenza and Tdap vaccines in the pediatrician's office; this allows for increased access to vaccination for new fathers and mothers as well as other family members. Approaching families and offering Tdap and influenza vaccinations during routine well-infant and child visits can—and should—be incorporated easily into all primary care office settings.
In-office vaccination of parents has been shown to be feasible, affordable, and convenient.3,4 Protecting infants and children from pertussis and influenza allows them to blossom and grow into the healthy butterflies of our future.
KATHRYN S. MOFFETT, MD
Dr Moffett is associate professor of pediatrics and medical student clerkship codirector in pediatrics at West Virginia University in Morgantown. She is also division chief of pediatric infectious diseases and director of the Mountain State Cystic Fibrosis Center in Morgantown. Financial disclosures: Speakers Bureau for GlaxoSmithKline, Merck & Co, Inc, Novartis, and Sanofi-Pasteur.
1. McIntyre P, Wood N. Pertussis in early infancy: disease burden and preventive strategies. Curr Opin Infect Dis. 2009;22:215-223.
2. Burke BL Jr, Nesmith CC, Ott RE, Hedrick ML. Through with the flu: how free family and caregiver immunization protects sick neonates. Clin Pediatr (Phila). 2010;49:20-23.
3. Coudeville L, van Rie A, Andre P. Adult pertussis vaccination strategies and their impact on pertussis in the United States: evaluation of routine and targeted (cocoon) strategies. Epidemiol Infect. 2008;136:604-620.
4. Walter EB, Allred N, Rowe-West B, et al. Cocooning infants: Tdap immunization for new parents in the pediatric office. Acad Pediatr. 2009;9:344-347.
See CON discussion on next page.