Acceptance of a Parent Influenza Vaccine Program (IVP) in a NICU

Background:

Influenza vaccine is not recommended for infants <6 months of age, yet this is one of the highest risk populations for disease acquisition and hospitalization. Parents can best protect their babies by obtaining influenza vaccine for themselves and their families.  Making vaccine free, convenient and accessible to parents of high risk newborns may improve parental vaccine coverage and thereby protect this high risk group of babies.

Objective: To develop and implement an IVP to immunize parents of infants hospitalized in a NICU. Immunization was discussed with all families and provided to those who consented and whose babies were hospitalized ≥5 days.    

Methods:

The program was presented by the Infection Control Practitioner (ICP) to a multidisciplinary team for feasibility, legality and acceptance. The process included educating staff to empower them to begin the influenza vaccine conversation with families and provide a vaccine information statement to parents interested in receiving vaccine.  The ICP then met with the parents to answer questions and provide additional education.  Parents were vaccinated after consenting.  

Results:

In 2007-08, the IVP started in late January after institutional oversight was completed and concluded the end of February.  During this period, 101 infants were hospitalized at least 5 days.  17 parents had already been vaccinated.  Twenty parents of 15 infants were vaccinated through the nursery IVP.  Overall during the first year, parents of 32% of infants were vaccinated. 

During 2008-09 season, beginning in November 2008, 140 babies hospitalized for 5 days or more.  47 parents had received the vaccine from another source.  44 parents of 33 infants (34 % of those with an  unvaccinated parent) received vaccination through IVP for a total vaccine coverage of 57% (significantly improved from the prior year, P = .0002).  Reasons to refuse vaccination reflected those noted in the general population. 

Conclusions:

The IVP was generally well accepted by parents but further attention to addressing vaccine misconceptions among the parents is needed.  Further success depends on making the program autonomous within the NICU, which will ensure that IVP becomes routine practice among bedside clinicians. Future plans include incorporating Tdap into our parent immunization program and evaluation of staff satisfaction with an IVP and their adherence with institutional vaccine recommendations.