Advocating for Childcare Employee Single-Dose Tdap Vaccination to Combat Infant Pertussis

Incidence rates of pertussis have been higher over the past 5 years than at any time since the first pertussis vaccine became widely available, with infants younger than 12 months old being particularly vulnerable. Once infected, infants may experience severe respiratory symptoms and incur high rates of hospitalization, and they account for the vast majority of pertussis-related deaths each year. With the diminished effectiveness of herd immunity, experts increasingly rely on cocooning to protect at-risk populations against infectious diseases such as pertussis. Cocooning calls for vaccination of all close contacts of vulnerable individuals, including childcare employees. Despite government recommendations, only 11 states address employee tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccination in their childcare regulations. Advanced practice nurses can play a significant role in protecting infants younger than 12 months old through initiating and supporting advocacy efforts at the state level for childcare employee Tdap vaccination. This article explores initial advocacy steps to be taken by advanced practice registered nurses to address this important issue.