Improving influenza immunisation for high-risk children and adolescents

Maria T. Britto · Geralyn M. Pandzik · Jeanne Weiland · Keith E. Mandel

34 citations0/0 files storedBMJ Quality & Safety

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Vaccine Coverage and Hesitancy Health Policy Implementation Science Clinical practice guidelines implementation

Abstract

OBJECTIVE: To improve influenza vaccination rates for high-risk children and adolescents. METHODS: During the 2004-5 influenza season, 5 regional cystic fibrosis (CF) centres, 6 hospital clinics that participated in a similar initiative the previous year, 4 new hospital clinics, and 39 community-based paediatric practices implemented a multicomponent change package consisting of nine improvement strategies designed to increase immunisation of high-risk patients. Each site was encouraged to adopt and customize the improvement strategies to meet their specific culture and needs. The main outcome measure was the proportion of the target population immunised. Surveys sent to the community practices were summarised. RESULTS: The intervention targeted a total of 18 866 high-risk children and 9374 (49.7%) received the influenza vaccination. Community-based practices that actively participated in the collaborative reported using significantly more intervention strategies (mean (SD) 7.4 (2.3) vs 4.6 (1.5), respectively, p = 0.001) and achieved higher immunisation rates (59.3% (13.6%) vs 43.7% (20.5%), respectively, p = 0.01) than non-participating practices. The most frequently implemented change concepts were posters in the office, walk-in clinics or same-day appointments and reminder phone calls. The interventions deemed most helpful were weekend or evening "flu shot only" sessions, walk-in or same-day appointments, reminder calls and special mailings to families. CONCLUSIONS: Implementation of the change package, based on evidence and diffusion of innovation theory, resulted in higher immunisation rates than typically reported in the medical literature, especially for the community-based primary care practices.

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References

2019Diffusion of Innovations 1 2015Diffusion of Innovations 2008Recommendations of the Advisory Committee on Immunization Practices (ACIP)2000Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults11The names and affiliations of the Task Force members are listed on page v of this supplement and at http://www.thecommunityguide.org22Some of this material was published previously in: Shefer A, Briss P, Rodewald L, et al. Improving immunization coverage rates: an evidence-based review of the literature. Epidemiol Rev 1999;20:96–142.2005Patient reminder and recall systems to improve immunization rates 1992Improving Influenza Vaccination Rates in Children With Asthma: A Test of a Computerized Reminder System and an Analysis of Factors Predicting Vaccination Compliance 2000Influenza vaccination in children with asthma in Health Maintenance Organizations 2004Identification and Recall of Children With Chronic Medical Conditions for Influenza Vaccination

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2008Influenza vaccination coverage in patients with cystic fibrosis followed at 12 care centers in the Greater South Region of France for the season 2005/2006 2015Vaccination of adolescents with chronic medical conditions: Special considerations and strategies for enhancing uptake 2021Improving Influenza Vaccination in Children With Comorbidities: A Systematic Review

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