Highly Relevant Study by Andrew Dylag - Article Example

The article, ‘Administration of Tetanus, Diphtheria, and Acellular Pertussis Vaccine to Parents of High-Risk Infants in the Neonatal Intensive Care Unit’ is a highly relevant study by Andrew M. Dylag and Shetal I. Shah primarily because it focuses on preventive measures to control the infection of the diseases in the infants. The study was conducted in the Stony Brook University Medical Center, New York from July 2007 to October 2007. The study is important because the increasing incidence of pertussis, despite vaccination has become a major cause of concern for the medical fraternity. The feasibility study was conducted to measure the role of vaccination in the parents in controlling the infection of pertussis in susceptible infants. This type of epidemiological study was applied because vaccination of the parents and adults, who are in constant contact with the infants is still not considered as one of the essential means of controlling the spread of pertussis in the infants.
Problem Statement
Identification of measures of prevention of the transmission of Bordetella Pertussis to young infants was the key factor of the study. The study was designed to explore whether the vaccination of parents was also one of the contributing factors in the increasing incidence of pertussis amongst infants.
Purpose of the article
Bordetella Pertussis has become one of the main causes of morbidity and mortality amongst infants. It is assumed that the parents may also be the most important carrier of the Pertussis virus and the result of the study would encourage vaccination of parents and adults as a major preventive measure to control the spread of pertussis amongst vulnerable infants. The article highlights the probable sources of infections and focuses on the vaccination of parents so the infants can be safeguarded against the dreaded disease.
Hypothesis
The study has followed the null hypothesis
• That parent may be the major carrier of the pertussis virus that could be transmitted to the infants.
• Vaccination of parents can become a significant preventive measure for reducing the incidence of Bordetella Pertussis amongst young infants.
Research design and methodology adopted
The study was conducted in the neonatal intensive care unit of Stony Brook University Medical Center, New York from July 1, 2007, to October 30, 2007. During the period, 358 infants with gestational age ranging from 23 weeks to 42 weeks were admitted into NICU, and 495 of 592 eligible parents were offered vaccination. 430 parents agreed to participate in the program. The nursing and other staff were adequately prepared to disseminate information regarding the risks and benefits of the immunization e program. The vaccination was carried out as per the guidelines of the TdaP vaccine of Sanofi Pasteur, France.
Consent forms with pertinent information like parents age, infants age, Apgar score, race, discharge date, vaccine lot number, healthcare worker, medical imperative like allergy to latex, fever, bleeding disorder, history of seizures, history of Guillain-Barre syndrome(if any), etc. were sought to assess contraindications for vaccination. Parents who refused were also asked to divulge the reasons for their refusal. Parents were excluded in the cases where there was noninvolvement of the father, childcare services and parents involved in neonatal palliatives care. Microsoft Access was used to create numerical data and analysis was based on students’ t-test with P < 0.05 which gave credibility to the study.
The large sample size ensured greater accuracy and reduced bias significantly. The major limitation of the study was that it did not take into account the financial considerations of the vaccinations that would be imposed on the health authorities and the parents.

Discussion on data analysis and interpretation
The vaccination was carried out under standard conditions and guidelines of the vaccine administration process. 430 parents were vaccinated and 55 refused to cite reasons like disbelief in the vaccination and not perceiving pertussis as life-threatening for infants. All the parents of infants less than 32 weeks were either vaccinated or were not immunized due to palliative infant care, paternal indifference, or involvement of childcare services. The data analysis was the major tool for the results. The nonimmunization increased with the infants’ gestational age and vaccination within 72 hours of infants’ NICU admission remained significantly high for the whole period of the study.
Pertussis is life-threatening especially in the cases where the immunization has been delayed or the infant has respiratory problems. The study has revealed that the TdaP vaccination of parents has been dismally low (just around 2%) and has reaffirmed that the parents may be the main source of the carrier of the virus. The awareness creation through the dissemination of information regarding TdaP in the NICU considerably increased the immunization of the parents.
Conclusion
The study has emphatically asserted the need for immunization of parents to protect the newborn from pertussis infection and probable death from the disease. There is a significant lack of awareness regarding the efficacy of the TdaP vaccine and immunization of the adults/ parents as an effective preventive measure for protecting children from pertussis.
Indeed, the research study has been critical in identifying the effective means of preventing and controlling the rising cases of Bordetella Pertussis infection in infants.  Read More