Cocooning strategy: Pertussis vaccination coverage rate of parents with a new-born in 2016 and 2017 in France

BACKGROUND

The "cocooning" strategy was introduced in 2004 to protect infants too young to be vaccinated against pertussis, by immunizing their parents and close relatives. The study objective was to assess its implementation 12 years after its introduction by estimating the pertussis vaccination coverage rates (VCR) among parents of newborns.

MATERIALS AND METHODS

Pertussis VCR were estimated among all women who gave birth and men who took paternity leave, in 2016 or 2017, from a 1/97th random sample of French claims data. Two distinct study periods were defined based on current recommendations for the cocooning strategy: the "common practice" and the "parental project" periods.

RESULTS

In 2016, the pertussis VCR of women having given birth and men having taken paternity leave was 47.2 and 47.1%, respectively (46.1 and 45.6% in 2017, respectively). About one quarter of vaccinations were performed during the "parental project" period, with the vaccine most frequently reimbursed during the month of childbirth for women (57.1% in 2016 and 49.4% in 2017) and before or during the month the paternity leave began for men (about 78% in both 2016 and 2017). General practitioners were the main prescribers in private practice, even during the "parental project" period.

CONCLUSION

To optimize the protection for infants, the main objective of the cocooning strategy, pertussis immunization coverage of adults and seniors needs to be improved. Moreover, cocooning vaccination linked to a parental project needs to be performed earlier, during pregnancy (for those around the mother) or in immediate post-partum (e.g., during the maternity stay).

Hostility, flooding, and relationship satisfaction: Predicting trajectories of psychological aggression across the transition to parenthood

Psychological aggression has been shown to have harmful effects on both partners, sometimes above and beyond the effects of physical aggression. However, very little is known about psychological aggression during the transition to parenthood. The transition to parenthood is a time where relationship satisfaction often declines and stress increases, which may put the couples at higher risk for psychological aggression. The purpose of this study was to examine if prenatal risk factors related to interpersonal style (specifically, emotional flooding and hostility) predict changes in psychological aggression from pregnancy to 2 years postpartum. Ninety eight couples took part in this study. The couples completed self-report questionnaires during pregnancy, 1 year postpartum, and 2 years postpartum. Both partners were asked about perpetrating and experiencing psychological aggression in their current relationship. Two level Hierarchical Linear Models (HLMs) were used to examine longitudinal associations between hostility, flooding, and psychological aggression. For women, hostility during pregnancy was a significant longitudinal predictor of psychological aggression. For men, flooding was a significant longitudinal predictor of psychological aggression. For both men and women, relationship satisfaction partially mediated the relationship between flooding/hostility and psychological aggression, indicating that women's hostile attitudes and men's tendency to be flooded tend to erode relationship quality, leading to increases in psychological aggression. This may represent a classic demand-withdraw dynamic in couples. The results indicate hostility for women and flooding for men are potential prenatal risk factors for future psychological aggression. Implications and future research directions are discussed. Aggr. Behav. 42:134-148, 2015. © 2014 Wiley Periodicals, Inc.