Automated Screening of Hospitalized Children for Influenza Vaccination

Ari H. Pollack · Matthew P. Kronman · Chuan Zhou · Danielle M. Zerr

36 citations0/0 files storedJournal of the Pediatric Infectious Diseases Society

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Vaccine Coverage and Hesitancy Electronic Health Records Systems Medical Coding and Health Information

Abstract

BACKGROUND: This study was designed to determine whether an automated hospital-based influenza vaccination screening program leveraging the electronic medical record (EMR) increases vaccination rates. METHODS: We performed a retrospective cohort study of all children ≥6 months old admitted to medical, surgical, rehabilitation, or psychiatry services during influenza seasons between 2003 and 2012 at a tertiary care pediatric hospital. We compared influenza vaccination rates before (preintervention phase) and after (intervention phase) the introduction of an automated EMR intervention that utilized a nursing-based electronic screening tool to determine eligibility for influenza vaccine and facilitated vaccine ordering without requiring involvement of a physician or other provider. RESULTS: Overall, 42 716 (72.8%) of the 58,648 subjects admitted during the study period met inclusion criteria. The intervention phase included 20,651 admissions, of which 11 194 (54.2%) were screened. Screening increased significantly over time in the intervention phase (19.8%-77.1%; P < .001). In-hospital influenza vaccination rates increased from a mean of 2.1% (n = 472) of all subjects preintervention phase to 8.0% (n = 1645) in the intervention phase (odds ratio = 6.8; 95% confidence interval, 6.14-7.47). Of the 11 194 screened subjects, 5505 (49.2%) were found to have already been vaccinated at the time of screening. The screening process identified 478 (4.3%) subjects who were unable to receive vaccine for medical reasons, and an additional 2865 (25.6%) whose caregiver refused the vaccine. CONCLUSIONS: An automated, hospital-based influenza vaccination program integrated into the EMR can increase vaccinations of hospitalized patients and provide insight into the vaccination history and declination reasons for children not receiving the vaccine.

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References

2008Recommendations of the Advisory Committee on Immunization Practices (ACIP)2008Parents With Doubts About Vaccines: Which Vaccines and Reasons Why 2009Impact of Electronic Health Record-Based Alerts on Influenza Vaccination for Children With Asthma 2006Parents Concerned About Vaccine Safety 2012Barriers to and facilitators of child influenza vaccine – Perspectives from parents, teens, marketing and healthcare professionals 2009Influenza vaccination coverage among children and adults - United States, 2008-09 influenza season.2011Influenza vaccination coverage - United States, 2000-2010.2009Influenza vaccination coverage among children and adults - United States, 2008-09 influenza season.

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2019Pediatric Inpatient Immunizations: A Literature Review 2023Effectiveness of hospital-based strategies for improving childhood immunization coverage: A systematic review 2016Missed Opportunities for Influenza Vaccination Among Hospitalized Children With Influenza at a Tertiary Care Facility 2021Evaluation of a Clinical Decision Support Strategy to Increase Seasonal Influenza Vaccination Among Hospitalized Children Before Inpatient Discharge

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