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Vaccination des parents contre la coqueluche : proposition et évaluation de 2 pratiques professionnelles en maternité [Article de Revue]

 
[Pertussis vaccination for parents: proposal and evaluation of two professional practices in a maternity hospital]
DURAND C ; FLAMENT E ;
Service de pédiatrie, pôle Mère-Enfant, hôpital Sud Léman- 74164 Saint-Julien-en-Genevois
Archives de pédiatrie. 2011/04/01; 18(4) : 362-369
Summary: Contexte
La coqueluche du nourrisson reste un problème en France où les recommandations vaccinales ciblées des parents de type « cocooning » sont peu suivies.Objectifs et méthode
Dans une maternité de proximité, 2 interventions ont été étudiées en 2009 : information et prescription vaccinale (si éligibilité) en sortie de maternité (188 parents, groupe 1), versus proposition de réaliser la vaccination en maternité pour les 2 parents (190 parents, groupe 2). Les couvertures vaccinales des 2 groupes ont été réévaluées 6 semaines après la sortie.Résultats
Au début d’étude, 8 % des parents étaient à jour de la vaccination contre la coqueluche. Des données objectives concernant le statut vaccinal n’étaient rapidement disponibles que dans 42 % des cas. En fin d’étude, la moitié des parents du groupe 1 était vaccinée (53 %), versus 43 % des parents du groupe 2 en sortie de maternité, puis 64 % en fin d’étude. La stratégie de proposition vaccinale en maternité était la plus efficace (p = 0,03).Conclusion

La promotion des vaccinations parentales en maternité par le pédiatre est simple et efficace. Nous en discutons les modalités et les interactions et la complémentarité entre l’équipe périnatale et le médecin généraliste (RESUME D'AUTEUR)

Background
Despite good rates of immunization among children, an apparent increase in the incidence of pertussis disease in infants in France has been observed, mainly because of low vaccination coverage among adults. Guidelines drawn up in 2004 recommend a vaccination strategy called cocooning for parents, but those guidelines are rarely followed by the medical community. Raising the vaccination rate among parents to 65% and the extension of pertussis vaccine booster for people between 26 and 28 years old could help control the disease.
Objective and methods
In a primary healthcare setting in 2009, we studied 2 groups of 188 and 190 parents of newborns in a maternity unit. We proposed 2 strategies: information and vaccine prescription for both parents (if eligible) at the time of discharge from the maternity unit (group 1) or vaccination proposed to both parents during hospitalization in the maternity unit (group 2). After 6 weeks, the vaccination rates of both groups were compared.Results
Analysis shows that parents had insufficient knowledge of the disease. Parents were often unaware of their vaccination status. Hence, objective data concerning the vaccination status was quickly available for only 42% of the population, making determination of eligibility unreliable. Only 8% of the parents were up to date for pertussis vaccination in the last 10 years, whereas 90% of the parents had the opportunity for vaccination and 37% of them had been eligible before the pregnancy. At the end of the study, 53% of the parents in group 1 were vaccinated, showing the positive impact of the medical encounter and vaccine prescription. During the study, 40% of the parents in group 2 who were proposed immediate vaccination in the maternity unit accepted it. This increased to 43% of group 2 parents being immunized by the time they had left the maternity unit. Proposing the vaccination at the maternity hospital was the more effective of the 2 strategies (P = 0.03): at the end of the study, the objective was nearly reached with 64% of the parents being vaccinated.Conclusions
The promotion of parental vaccination by the pediatrician in the maternity ward is simple and effective. Medical encounters resulting from prescriptions made during hospitalization could raise awareness in general practitioners and enable them to identify eligible adults for pertussis vaccination and vaccinate themselves. There is a need to discuss the complementarity and interactions between perinatal teams and general practitioners within the community healthcare network.(RESUME D'AUTEUR)
Publication
FR, 2011/04/01

Pages
362-369

Language
Français

Published in
Archives de pédiatrie

ID notice
318840

Location Call number Status Date due Barcode
CCLIN Est
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Hospices Civils de Lyon
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http://cclin-sudest.chu-lyon.fr/
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CClin Sud-Ouest
CHU de Bordeaux
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33076 Bordeaux
Tél : 05.56.79.60.58
cclin.so@chu-bordeaux.fr
http://www.cclin-sudouest.com/

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