Pertussis vaccination in Child Care Workers: room for improvement in coverage, policy and practice

Abstract

BackgroundThe “Staying Healthy in Child Care” Australian guidelines provide for illness and disease exclusions and encourage vaccination of staff in child care settings, however these requirements are not subject to accreditation and licensing, and their level of implementation is unknown. This study aimed to describe pertussis vaccination coverage in child care workers in a regional area of northern NSW during 2010; review current staff pertussis vaccination practices; and explore barriers to vaccination.MethodsA cross sectional survey of all child care centre directors in the Hunter New England (HNE) area of northern NSW was conducted in 2010 using a computer assisted telephone interviewing service.ResultsNinety-eight percent (319/325) of child care centres identified within the HNE area participated in the survey. Thirty-five percent (113/319) of centres indicated that they had policies concerning respiratory illness in staff members. Sixty-three percent (202/319) of centres indicated that they kept a record of staff vaccination, however, of the 170 centre’s who indicated they updated their records, 74% (125/170) only updated records if a staff member notified them. Of centres with records, 58% indicated that fewer than half of their staff were vaccinated.ConclusionMany childcare workers have not had a recent pertussis immunisation. This potentially places young children at risk at an age when they are most vulnerable to severe disease. With increasing use of child care, national accreditation and licensing requirements need to monitor the implementation of policies on child care worker vaccination. Higher levels of vaccination would assist in reducing the risk of pertussis cases and subsequent outbreaks in child care centres.

Ethics of mandatory vaccination for healthcare workers

“…However, susceptibility rates of HCWs to measles in Europe have been found to range from 3% to 17% [27]. Low vaccination rates have been reported for the booster dose of pertussis among HCWs in France (33%) [1] and Australia (13-23%) [28].…”

Community vaccine perceptions and its role on vaccination uptake among children aged 12-23 months in the Ileje District, Tanzania: a cross section study

“…Ileje district is among the districts with vaccination uptake consistently below 90% over the past ten years with its most recent third dose pentavalent coverage being 69% with a dropout of 15% [ 13 ]. Vaccination uptake is influenced by various factors that include social and economic status of the family [ 14 , 15 ], mother health status and experience in utilization of health care services [ 16 , 17 ], age and education of the mother [ 18 – 20 ], polygamies [ 21 ], physical factors like distance to the facility [ 22 ], area of residence [ 23 , 24 ] and facility factors including lack of vaccines and diluents [ 25 ], staff shortage [ 26 ], lack of policy on immunization [ 27 ], lack of adequate transport facilities [ 12 ] and type of care providers [ 28 ]. Parents are sometimes reluctant to send their children for vaccination [ 29 ].…”

Pertussis: novas estratégias de vacinação para prevenção de uma antiga doença

“…Baixa percepção sobre os riscos da coqueluche tem sido associada a baixas coberturas vacinais em adolescentes e adultos e, nos EUA, Austrália e Europa, as coberturas vacinais só aumentaram significativamente depois do registro de epidemias e da exigência de vacinação para escolares e profissionais de saúde [7][8][9][10][11]13,14,[91][92][93][94][95][96] . Pediatras e profissionais de saúde em departamentos neonatais França 73 Profissionais de saúde em contato direto com o paciente Do ponto de vista de saúde pública, considera-se que a efetividade (impacto após introdução na rotina) é mais relevante do que a eficácia avaliada através de estudos clínicos realizados em condições controladas (préregistro).…”

“…Prematuros são de alto risco para complicações da coqueluche e, como a passagem de anticorpos só ocorre no último trimestre de gestação, mesmo que a mãe tenha sido vacinada, não estarão protegidos passivamente, sendo fundamental que pediatras e obstetras eduquem os familiares sobre a importância da estratégia cocoon e que também se vacinem, para evitar o risco de transmitir a coqueluche a esses bebês. O mesmo é válido para os cuidadores, como babás e profissionais que trabalham em berçários e creches [19][20][21][22][23][24]73,87,96 .…”