Journals / Hitit Medical Journal / 2026 / Cilt: 8 Sayı: 2

Knowledge and Attitudes Toward the Cocooning Strategy for Pertussis and Influenza Among Pregnant and Early Postpartum Mothers

Gebeler ve Erken Postpartum Annelerde Boğmaca ve İnfluenza İçin Koza Aşılama (Cocooning) Stratejisine Yönelik Bilgi ve Tutumlar

Pages
259–271
Publication Date
2026-06-29
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

This study provides a baseline reference for the pre-implementation period of national Tdap vaccination in pregnancy.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective:: Pertussis and influenza remain important causes of illness and death in early infancy.
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Key Findings & Data:Because primary vaccination begins late in the first months of life, maternal and household immunization—known as the cocooning strategy—is essential for newborn protection.This study aimed to assess the knowledge and attitudes of pregnant and early postpartum mothers toward the cocooning strategy for pertussis and influenza, and to identify sociodemographic factors influencing awareness and vaccine acceptance.
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Conclusion & Impact:This study provides a baseline reference for the pre-implementation period of national Tdap vaccination in pregnancy.
🔬Design:Survey & Empirical Study
📍Scope:2023 Verileri
⚙️Variables:Boğmaca · İnfluenza · Koza Stratejisi

Abstract

Objective:: Pertussis and influenza remain important causes of illness and death in early infancy. Because primary vaccination begins late in the first months of life, maternal and household immunization—known as the cocooning strategy—is essential for newborn protection.This study aimed to assess the knowledge and attitudes of pregnant and early postpartum mothers toward the cocooning strategy for pertussis and influenza, and to identify sociodemographic factors influencing awareness and vaccine acceptance. Material and Methods: A descriptive, cross-sectional study was conducted between March 2023 and March 2025 at the Department of Pediatrics, Ordu University Training and Research Hospital. A total of 382 eligible participants (pregnant or ≤6 months postpartum mothers) were included. Data were collected using a structured 28-item questionnaire evaluating sociodemographic characteristics and knowledge–attitude domains related to cocooning. Descriptive analyses, chi-square tests, logistic regression, and CHAID/CART algorithms were performed using SPSS v28, with significance set at p<0.05. Results: More than half of participants were aged 20–30 years (53.4%), and 44.2% were pregnant. Awareness levels were low: 53.7% had never heard of pertussis, and 66.5% were unaware that it is vaccine-preventable. Only 13.1% identified maternal vaccination as the most effective means of neonatal protection. “Lack of information” was the most common reason for vaccine hesitancy (pertussis: 72.8%; influenza: 45.6%). Higher education and income were significantly associated with greater awareness, accurate timing knowledge, and reliance on scientific sources (p<0.001). Conclusion: Awareness and acceptance of maternal pertussis and influenza vaccination remain insufficient, with decisions heavily influenced by healthcare provider recommendations. Strengthening antenatal counseling, improving professional training, and integrating cocooning education into routine maternal care are essential. This study provides a baseline reference for the pre-implementation period of national Tdap vaccination in pregnancy.

Özet

Giriş: Boğmaca ve influenza, erken bebeklik döneminde önemli morbidite ve mortalite nedenleri olmaya devam etmektedir. Birincil aşılama yaşamın ilerleyen aylarında başlayabildiği için, maternal ve hane içi aşılama—kokonlama stratejisi—yenidoğanların korunmasında kritik bir rol oynamaktadır. Bu çalışma, gebe ve erken postpartum dönemdeki annelerin boğmaca ve influenza için kokonlama stratejisine yönelik bilgi ve tutumlarını değerlendirmeyi ve farkındalık ile aşı kabulünü etkileyen sosyodemografik belirleyicileri ortaya koymayı amaçlamıştır. Gereç ve Yöntem: Mart 2023–Mart 2025 tarihleri arasında Ordu Üniversitesi Eğitim ve Araştırma Hastanesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı’nda tanımlayıcı, kesitsel bir çalışma yürütülmüştür. Çalışmaya toplam 382 uygun katılımcı (gebe veya ≤6 ay postpartum anneler) dahil edilmiştir. Veriler, sosyodemografik özellikler ile kokonlamaya ilişkin bilgi-tutum alanlarını değerlendiren 28 maddelik yapılandırılmış bir anketle toplanmıştır. SPSS v28 kullanılarak tanımlayıcı istatistikler, ki-kare testleri, lojistik regresyon ve CHAID/CART algoritmaları uygulanmış; anlamlılık düzeyi p<0.05 olarak kabul edilmiştir. Bulgular: Katılımcıların çoğu 20–30 yaş arasındaydı (%53,4) ve %44,2’si gebeydi. Farkındalık düşüktü: %53,7’si boğmacayı hiç duymamış, %66,5’i hastalığın aşı ile önlenebilir olduğunu bilmemekteydi. Yalnızca %13,1’i maternal aşının yenidoğanı korumada en etkili yöntem olduğunu belirtmiştir. “Bilgi eksikliği” en sık bildirilen tereddüt nedeniydi (boğmaca: %72,8; influenza: %45,6). Daha yüksek eğitim ve gelir düzeyi, daha iyi farkındalık, doğru zamanlama bilgisi ve bilimsel kaynaklara yönelim ile anlamlı derecede ilişkiliydi (p<0.001). Sonuç: Maternal boğmaca ve influenza aşılamasına yönelik farkındalık ve kabul yetersizdir; kararlar büyük ölçüde sağlık profesyoneli önerilerine dayanmaktadır. Antenatal danışmanlığın güçlendirilmesi, profesyonel eğitimin artırılması ve kokonlama eğitiminin rutin maternal bakıma entegre edilmesi gerekmektedir. Çalışma, gebelikte ulusal Tdap aşılama politikasının uygulanmasından önceki dönem için değerli bir başlangıç verisi sunmaktadır.

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Cite This Article

Altınok, E. İ., Ertürk, E. Y., Gümüş, C. Y. (2026). Knowledge and Attitudes Toward the Cocooning Strategy for Pertussis and Influenza Among Pregnant and Early Postpartum Mothers. Hitit Medical Journal, Cilt: 8 Sayı: 2, 259–271. https://doi.org/10.52827/hititmedj.1829400

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