Medical News Today
Doctors are wrapping babies in vaccine “security blankets” to protect them from disease in a little-known tactic called “cocooning.”
Cocooning is a way of wrapping infants too young to be vaccinated against pertussis in a blanket of immunity. Pertussis is commonly called whooping cough because of the distinctive “whoop” gasping sound an infected patient makes when he or she coughs. Physicians say if the baby is too young to get vaccinated, the next best thing is to ensure the people near the baby are healthy. Cocooning vaccinates the baby’s mother and other relatives near the child with the protective pertussis shot, explains Texas Medicine magazine, the official publication of the Texas Medical Association (TMA).
This technique is important, physician experts say, because infants are most likely to contract whooping cough, and it can make them very ill. Statistics bear that out. The Texas Department of State Health Services reports that, as of early December, the only Texans who died from pertussis last year were babies younger than three months old.
Infants are too young to be immunized against pertussis so they stand a greater chance of getting sick from it. They cannot receive their first pertussis vaccine until they are 2 months old, and are not fully protected until they receive multiple doses, usually when they reach 15 to 18 months old.
Health officials have begun cocooning infants in the Williamson County area north of Austin, due to a serious pertussis outbreak there. Far more Williamson County residents have contracted whooping cough than the state average – approximately 185 cases per 100,000 residents in 2009, compared with fewer than 10 people per 100,000 statewide as of early December.
“The goal of the cocooning project is that everyone who comes in contact with a newborn infant receives a Tdap vaccination,” says David W. Martin, MD, chief medical officer of St. David’s Round Rock Medical Center in Round Rock, in the heart of Williamson County. Tdap is the tetanus, diphtheria, and pertussis vaccine for adults. The Centers for Disease Control and Prevention recommends infants receive the first three doses of the DTaP (child version) vaccine at 2, 4, and 6 months of age. Children then should receive the fourth shot between 15 and 18 months of age, and a fifth when they enter school, at 4 to 6 years of age.
In the Williamson County cocooning project, physicians and other health officials attempt to educate and administer the Tdap shot to mothers who come to the Round Rock hospital to deliver their babies. The goal is to teach the mother about the importance of immunization, and to vaccinate her and others close to the baby.
“We hope to decrease the number of infants with pertussis as a result of the [cocooning] initiative,” Dr. Martin says. TMA recently sponsored a cocooning seminar for physicians and nurses at the Round Rock hospital. (TMA created a video of the program as well, as a teaching tool for physicians.) TMA also sponsors Be Wise – ImmunizeSM, an ongoing public health initiative to vaccinate and educate people that vaccines are important, safe, and effective.
“The response to the cocooning project has been positive. All health care professionals realize pertussis is a problem in Williamson County and want to [reduce it],” says C. Mary Healy, MD, who presented the TMA seminar. Dr. Healy is director of Vaccinology and Maternal Immunization at Houston’s Texas Children’s Hospital Center for Vaccine Awareness and Research. Ben Taub General Hospital in Houston and Parkland Memorial Hospital in Dallas also have implemented cocooning.
Dr. Healy believes patient education is critical to eliminating the spread of whooping cough. “Once people find out how serious pertussis can be and how effective the Tdap vaccine is, they’re willing to be immunized,” Dr. Healy says.
Public health officials in Williamson County are uncertain as to why pertussis has struck locally. “We really wonder in Williamson County if we’re that much worse than the rest of Texas, or if we’re just looking for it harder,” says Edward J. Sherwood, MD, FACP, chair of TMA’s Committee on Infectious Diseases, and member of TMA’s Be Wise – Immunize advisory panel. “But the case counts are so big in the county that I have to believe it’s a real outbreak,” says the former health authority for Williamson County.
TMA is the largest state medical society in the nation, representing nearly 45,000 physician and medical student members. It is located in Austin and has 120 component county medical societies around the state. TMA’s key objective since 1853 is to improve the health of all Texans. TMA Foundation is the philanthropic arm of the association and raises funds to support the public health and science priority initiatives of TMA and the family of medicine.