Seasonal Influenza Vaccination Rates in the HIV Outpatient Study--United States, 1999-2013

Abstract

To the Editor—Due to the high burden of estimated annual deaths and hospitalizations associated with influenza epidemics in the United States [1, 2], annual influenza vaccination is recommended for persons aged ≥6 months, and for those who are at increased risk of influenza-related complications, including persons with human immunodeficiency virus (HIV) infections [3]. In 2011, we published data from the HIV Outpatient Study (HOPS), an open prospective HIV cohort study of HIV-infected outpatients seen in 9 well-established community-based private practices, public health clinics, and university-based clinics, describing annual rates of influenza vaccination among HIV-infected persons in care during influenza seasons from 1999 to 2008 [4]. We found that an average of 35% of HOPS participants received an influenza vaccination while under observation during the time period under investigation. This letter serves as an update to the previous analysis by including 5 years of additional data describing influenza vaccination rates among HOPS participants through 30 June 2013. Among 6548 active patients (patients with at least 1 clinical encounter during the time period under investigation), 4788 were vaccinated at any time between 1 July 1999 and 30 June 2013. The annual vaccination rates ranged from a low of 26.4% to a high of 50.9% (average, 38.7%; linear regression trend P = .043; Figure 1) during the influenza seasons studied. The HOPS recorded the highest rate of vaccination during the 2009–2010 H1N1 influenza season, but that level was not sustained in subsequent seasons. Although we detected an overall temporal increase in influenza vaccination rates over the 14-year period, the observed rates continued to be consistently lower than published recommendations and below the goal of 70% set for Healthy People 2020 [3, 5], underscoring the need for improving adherence to guidelines for annual influenza vaccination for HIV-infected persons. Percentage of human immunodeficiency virus (HIV)-infected participants vaccinated by influenza year—the HIV Outpatient Study, United States, 1999–2013 (N = 4788). Acknowledgments. The HIV Outpatient Study Investigators include the following persons and sites: John T. Brooks, Kate Buchacz, Marcus D. Durham, Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; Harlen Hays, Kathleen C. Wood, Darlene Hankerson, Rachel Debes, Thilakavathy Subramanian, Carl Armon, Bonnie Dean, Dana Bryant Cerner Corporation, Vienna, Virginia; Frank J. Palella, Joan S. Chmiel, Saira Jahangir, Conor Daniel Flaherty, Jerian Denise Dixon-Evans, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Kenneth A. Lichtenstein, Cheryl Stewart, National Jewish Health, Denver, Colorado; John Hammer, Kenneth S. Greenberg, Barbara Widick, Rosa Franklin, Rose Medical Center, Denver, Colorado; Bienvenido G. Yangco, Kalliope Chagaris, Infectious Disease Research Institute, Tampa, Florida; Doug Ward, Troy Thomas, Patricia Avery, Dupont Circle Physicians Group, Washington, D.C.; Jack Fuhrer, Linda Ording-Bauer, Rita Kelly, Jane Esteves, State University of New York, Stony Brook; Ellen M. Tedaldi, Ramona A. Christian, Faye Ruley, Dania Beadle, Princess Graham, Temple University School of Medicine, Philadelphia, Pennsylvania; Richard M. Novak, Andrea Wendrow, Renata Smith, University of Illinois at Chicago; Benjamin Young, Barbara Widick, Mia Scott, APEX Family Medicine, Denver, Colorado. Disclaimer. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the CDC. Financial support. This work was supported by the CDC (contract numbers 200-2001-00133, 200-2006-18797 and 200-2011-41872). Potential conflicts of interest. All authors: No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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