NEW YORK (Reuters Health) - New research suggests that the newborn (neonatal) intensive care unit (NICU) is a good setting for offering the tetanus, diphtheria, and acellular pertussis vaccine (TdaP) to the parents of high-risk infants to protect them against common childhood infections.

The US Centers for Disease Control and Prevention recommends 1 dose of TdaP for previously unimmunized adults who will have close contact with NICU infants younger than 12 months, according to a study published in the journal Pediatrics.

In the current study, Dr. Shetal I. Shah and Andrew M. Dylag from the State University of New York, Stony Brook, assessed the feasibility of administering TdaP to parents of high-risk infants in a high-level NICU.

From July to October 2007, parents of NICU-admitted infants were presented with an information letter at their child's bedside explaining the risks and benefits of TdaP vaccination. The risks of pertussis infection were reinforced with NICU staff and the importance of offering vaccination to parents was emphasized. Vaccination was provided free of charge, 20 hours per day.

A total of 352 children between 23 and 42 weeks of age were admitted to the NICU during the study period. Of 598 eligible parents, 495 (82.8 percent) were offered TdaP.

The researchers note that at the start of the study less than 2 percent of parents had received TdaP.

Overall, 430 parents received TdaP, yielding a vaccination rate of 86.9 percent in the screened population. Fifty-five parents (11.1 percent) refused vaccination, usually because they believed pertussis was not an important health threat or because of disbelief in the vaccine. Ten parents (2.0 percent) had conditions that ruled out vaccination for medical reasons.

Parental age was not a determinant of vaccination, the report indicates. Infant characteristics such as shorter length of stay and higher birth weight, correlated with not being offered the vaccine.

TdaP vaccination was well tolerated and no allergic reactions were noted, the findings show.

"Additional multicenter trials are required to determine whether this immunization rate is reproducible in other NICUs and sustainable for periods greater than the 4-month trial period," the authors conclude.

SOURCE: Pediatrics, September 2008.

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