The new Center for Vaccine Awareness and Research at Texas Children’s Hospital announced that it will implement the nation’s first major “cocoon strategy” vaccination program to protect newborn infants from the life-threatening infection pertussis, more commonly known as whooping cough.

Whooping cough is a highly-contagious bacterial infection of the respiratory system. While the disease can occur at any age, whooping cough can be particularly serious and even life-threatening to very young infants. Recent statistics show that whooping cough is on the rise again. According to the Centers for Disease Control and Prevention (CDC), over 50,000 cases of whooping cough were reported in the United States in 2004 and 2005, the largest number since the 1950s. This increase is due to an epidemic of pertussis in adolescents and adults who have lost their immunity from their childhood vaccines and need a booster vaccine. While this population has less severe consequences from the infection, they are the source of its spread to infants who are too young to be protected by their own vaccinations.

The cocoon strategy is the process of vaccinating the baby’s mother and other adolescent and adult family members who will be in close contact with the infant, so that the baby is surrounded by family members who can not spread pertussis. Babies under six months old are too young to have received all three doses of the whooping cough vaccine, and studies show that more than 75 percent of infected babies get pertussis from family members.

“The idea behind the cocoon strategy is that the vaccinated family members can block transmission of the infection to the unvaccinated or incompletely vaccinated infant,” said C. Mary Healy, M.D., program leader and director of Vaccinology and Maternal Immunization at the Center for Vaccine Awareness and Research.

Through this program, Texas Children’s Center for Vaccine Awareness and Research will administer whooping cough booster vaccines, called Tdap, to approximately 5,800 families at Houston’s Ben Taub General Hospital (BTGH), administering over 17,000 shots in the first year.

According to Dr. Healy, the cocoon strategy involves first educating the mother and her family about pertussis and the Tdap vaccine before administering the booster vaccine. The program team, working in collaboration with BTGH staff, is prepared to communicate with families in both English and Spanish. The first year of this program is made possible by a grant from the Baylor Methodist Community Health Fund.

“This program enables us to provide whooping cough education and booster vaccines to adolescent and adult family members who need it, helping protect the most vulnerable – newborn and young infants,” said Dr. Healy. “At the same time, we will explore efficient processes to optimize this intervention and potentially reduce serious pertussis disease in our community.”

Using the cocoon strategy vaccination model to prevent whooping cough has been recommended by the CDC since 2006, but has not been implemented by health care organizations.

“We commend Texas Children’s Center for Vaccine Awareness and Research for undertaking this important project,” said Dr. Melinda Wharton, deputy director of the National Center for Immunization and Respiratory Diseases at the CDC. “Not only will it benefit the families receiving the vaccine, but we are sure it will contribute to our understanding of pertussis prevention.”

Dr. Healy said the rise in pertussis cases is largely attributed to the fact that the vaccine most people received during childhood eventually wears off. Adolescents and adults who do not receive a booster vaccine are susceptible to this infection. In addition, young infants do not have full immunity until they have received three doses of the vaccine.