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A cross sectional survey of attitudes, awareness and uptake of the parental pertussis booster vaccine as part of a cocooning strategy, Victoria, Australia

Ellen J Donnan12, James E Fielding13, Stacey L Rowe1, Lucinda J Franklin1* and Hassan Vally24

Author Affiliations

1 Victorian Government Department of Health, 50 Lonsdale Street, Melbourne, Victoria 3000, Australia

2 National Centre for Epidemiology and Population Health, College of Medicine and Biological Sciences, The Australian National University, Building 62, Cnr of Eggleston and Mills Roads, Canberra Australian Capital Territory 0200, Australia

3 Victorian Infectious Disease Reference Laboratory, 14 Wreckyn Street, North Melbourne, Victoria 3051, Australia

4 School of Public Health and Human Biosciences, La Trobe University, Melbourne, Victoria 3086, Australia

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BMC Public Health 2013, 13:676  doi:10.1186/1471-2458-13-676

Published: 23 July 2013



The Victorian Government Department of Health funded a diphtheria, tetanus and acellular pertussis vaccine for parents of infants from June 2009 to June 2012 as part of a cocooning strategy for the control of pertussis. The aim of this study was to assess parents’ attitudes and awareness of the vaccination program, and to estimate vaccine uptake.


A cross-sectional survey of 253 families with a child born in the first quarter of 2010 residing within five metropolitan and four rural local government areas in Victoria was conducted. Univariate analyses were performed to describe the relationship between demographic variables, knowledge and awareness of the disease, the vaccine program and vaccine uptake. Multivariate analyses examining predictors for awareness of the vaccine program and for the uptake of vaccination were also conducted.


One hundred and five families were surveyed (response rate 43%). Of these, 93% indicated that they had heard of ‘pertussis’ or ‘whooping cough’ and 75% of mothers and 69% of fathers were aware the pertussis vaccine was available and funded for new parents. Overall, 70% of mothers and 53% of fathers were vaccinated following their child’s birth, with metropolitan fathers less likely to be vaccinated as rural fathers (RR = 0.6, p = 0.002). Being a younger mother (p = 0.02) or father (p = 0.047), and being an Australian-born father (RR = 1.9, p = 0.03) were found to predict uptake of the vaccine in parents.


Parents indicated a reasonable level of knowledge of pertussis and a willingness to be vaccinated to protect their child. However, vaccine uptake estimates indicated further opportunity for program improvement. Future cocooning strategies would benefit from specifically targeting fathers and metropolitan maternity hospitals to increase vaccine uptake. Wider promotion of the availability of vaccine providers may increase uptake to maximise the success of cocooning programs. Further investigation of the effectiveness of the cocooning strategy in decreasing infant morbidity and mortality is required.

Diphtheria-tetanus-acellular; Pertussis vaccines; Parents; Cross-sectional studies; Victoria