title: Implementation of a pertussis immunization program in a teaching hospital: an argument for federally mandated pertussis vaccination of health care workers.
abstract: BACKGROUND
  As pertussis disease becomes more common, health care-associated outbreaks have been reported with increasing frequency. Often, these clusters are costly and labor intensive to investigate and contain. It is clear that health care workers are among the adults who transmit pertussis to susceptible infants. Recent focus on patient safety, together with a concern for protecting employees in the workplace and those they expose elsewhere, has spurred interest in optimizing measures to prevent infection and disease transmission. Shortly after a tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine adsorbed booster was licensed and became available, we designed, launched, and analyzed a campaign to immunize the employees of our institution against pertussis.
  
  
  METHODS
  To optimize acceptance of a tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine adsorbed booster by employees, we adopted a program consisting of a 3-phase publicity and educational model and a 3-phase vaccine delivery approach.
  
  
  RESULTS
  Despite extraordinary resources dedicated to this program, and our institution's better than average annual uptake of influenza vaccine, less than one third of our eligible employees were immunized. A significant number of employees declined to be vaccinated for inappropriate reasons.
  
  
  CONCLUSIONS
  A campaign of this kind is quite labor intensive and expensive, yet limited overall vaccine uptake was achieved. A federal mandate to require pertussis immunization of all health care workers appears to be a more effective way to protect our patients, employees, families, and society.
authors.affiliation: Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital, New Brunswick, NJ, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Calderon
authors.forename: Kristina N
authors.initials: KN
authors.lastname: Feja
authors.forename: Pat
authors.initials: P
authors.lastname: Ford
authors.forename: Lawrence D
authors.initials: LD
authors.lastname: Frenkel
authors.forename: Amy
authors.initials: A
authors.lastname: Gram
authors.forename: Diane
authors.initials: D
authors.lastname: Spector
authors.forename: Robert W
authors.initials: RW
authors.lastname: Tolan
mesh_terms: D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D004168:Diphtheria Toxoid / Q000008:administration & dosage; D006282:Health Personnel; D006784:Hospitals, Teaching; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D010567:Pertussis Vaccine / Q000008:administration & dosage*; D013745:Tetanus Toxoid / Q000008:administration & dosage; D016896:Treatment Outcome; D014917:Whooping Cough / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D004168:Diphtheria Toxoid; D010567:Pertussis Vaccine; D013745:Tetanus Toxoid