title: Acceptability of immunization in adult contacts of infants: possibility of expanding platforms to increase adult vaccine uptake.
abstract: OBJECTIVE
  Adult vaccination coverage is low and current strategies are unlikely to achieve Healthy People 2020 targets. We determined the attitude of adult infant contacts toward recommended adult vaccines and their willingness to receive vaccines should they be available during hospital visits or prenatal or infant clinic appointments.
  
  
  METHODS
  Survey of predominantly Hispanic, underinsured and medically underserved infant contacts at a county hospital in Houston, Texas where a pertussis cocooning program is offered.
  
  
  RESULTS
  Two hundred and eighty-five contacts (mean age 32.8 years [18-73]; 94.8% Hispanic) participated. Most were fathers (58.2%), followed by aunts (19%), and grandparents (12.3%). Participants used many health information sources. 221 (77.5%) considered healthcare providers the most influential on their decisions but only 51.6% reported healthcare visits within the prior year. Forty-one (14.4%) discussed family vaccinations during prenatal visits. Preferred locations for adult vaccination were hospital or clinic-based (96.5%). Lack of knowledge (22.8%), fear of pain/needles (14.7%), work commitments (14%), lack of transport (11.2%), cost (10.2%) and fear of side effects (5.3%) were barriers to vaccination. More males than females reported fear of pain/needles and work commitments (P 0.01 and P 0.02, respectively), and more females lack of transport (P<0.001) as barriers. Most planned to (76.1%) or had received (7%) pertussis vaccine; if available, 73.3%, 53.3% and 50.5% expressed willingness to receive vaccines against influenza, pneumonia and meningitis, respectively. Age, ethnicity or education was not associated with willingness to be vaccinated. Vaccine acceptance was higher in females than males for pertussis (P 0.04), influenza (P 0.008), pneumonia (P 0.04), and meningitis (P 0.006) vaccines by multiple regression analysis.
  
  
  CONCLUSIONS
  Most adults were willing to be vaccinated if offered during hospital visits or clinic appointments for mother or infant. Development and expansion of recommended immunization platforms, such as the cocooning platform, offers the opportunity to increase adult vaccination coverage.
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Rossmann Beel
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA; Ben Taub General Hospital, Houston, TX, USA.
authors.forename: Marcia A
authors.initials: MA
authors.lastname: Rench
authors.affiliation: Ben Taub General Hospital, Houston, TX, USA; Center for Vaccine Awareness and Research, Texas Children's Hospital, Houston, TX, USA.
authors.forename: Diana P
authors.initials: DP
authors.lastname: Montesinos
authors.affiliation: Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA; Ben Taub General Hospital, Houston, TX, USA; Center for Vaccine Awareness and Research, Texas Children's Hospital, Houston, TX, USA. Electronic address: chealy@bcm.edu.
authors.forename: C Mary
authors.initials: CM
authors.lastname: Healy
mesh_terms: D000293:Adolescent; D000328:Adult; D017028:Caregivers; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic / Q000379:methods; D013781:Texas; D014611:Vaccination / Q000706:statistics & numerical data*; D014612:Vaccines / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D014612:Vaccines
keywords: Attitudes; Cocooning; Immunization platform; Influenza; Pertussis; Vaccine coverage