Practice and Child Characteristics Associated With Influenza Vaccine Uptake in Young Children

OBJECTIVES: The objective of this study was to determine both practice and child characteristics and practice strategies associated with receipt of influenza vaccine in young children during the 2004–2005 influenza season, the first season for the universal influenza vaccination recommendation for all children who are aged 6 to 23 months. METHODS: Clinical and demographic data from randomly selected children who were aged 6 to 23 months were obtained by chart review from a community-based cohort study in 3 US counties. The proportion of children who were vaccinated by April 5, 2005, in each practice was obtained. For assessment of practice characteristics and strategies, sampled practices received a self-administered practice survey. Practice and child characteristics that predicted complete influenza vaccination were determined by using multinomial logistic regression. RESULTS: Forty-six (88%) of 52 sampled practices completed the survey and permitted chart reviews. Of 2384 children who were aged 6 to 23 months and were studied, 27% were completely vaccinated. The proportion of children who were completely vaccinated varied widely among practices (0%–71%). Most (87%) practices implemented ≥1 vaccination strategy. Complete influenza vaccination was associated with 3 practice characteristics: suburban location, lower patient volume, and vaccination strategies of evening/weekend vaccine clinics; with child characteristics of younger age, existing high-risk conditions, ≥6 well visits to the practice by 3 years of age, and any practice visit from October through January. CONCLUSIONS: Modifiable factors that were associated with increased influenza vaccination coverage included October to January practice visits and evening/weekend vaccine clinics.

[1]  E. Luman,et al.  Progress toward eliminating disparities in vaccination coverage among U.S. children, 2000-2008. , 2010, American journal of preventive medicine.

[2]  Mandy A. Allison,et al.  High influenza vaccination coverage in children with high-risk conditions during a vaccine shortage. , 2009, Archives of pediatrics & adolescent medicine.

[3]  R. Hornung,et al.  Influenza vaccine effectiveness among children 6 to 59 months of age during 2 influenza seasons: a case-cohort study. , 2008, Archives of pediatrics & adolescent medicine.

[4]  S. Clark,et al.  Physician perspectives regarding annual influenza vaccination among children with asthma. , 2008, Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association.

[5]  Ismael R Ortega-Sanchez,et al.  Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). , 2008, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[6]  J. Steiner,et al.  Impact of a severe influenza vaccine shortage on primary care practice. , 2007, American journal of preventive medicine.

[7]  C Joseph McCannon,et al.  The science of large-scale change in global health. , 2007, JAMA.

[8]  A. Kempe,et al.  Influenza vaccine supply, 2005–2006: did we come up short? , 2007, BMC Health Services Research.

[9]  L. Solberg.  Improving Medical Practice: A Conceptual Framework , 2007, The Annals of Family Medicine.

[10]  P. Melinkovich,et al.  Improving pediatric immunization rates in a safety-net delivery system. , 2007, Joint Commission journal on quality and patient safety.

[11]  M. Irigoyen,et al.  Influenza Vaccine Coverage and Missed Opportunities Among Inner-city Children Aged 6 to 23 Months: 2000-2005 , 2007, Pediatrics.

[12]  R. Hiatt,et al.  Large Multispecialty Group Practices and Quality Improvement: What Is Needed to Transform Care? , 2007, The Journal of ambulatory care management.

[13]  B. Canavan,et al.  Influenza vaccination coverage among children aged 6-23 months - six immunization information system sentinel sites, United States, 2005-06 influenza season. , 2006, MMWR. Morbidity and mortality weekly report.

[14]  M. Nowalk,et al.  Improving Influenza Vaccination Rates of High-Risk Inner-City Children Over 2 Intervention Years , 2006, The Annals of Family Medicine.

[15]  Jason Roy,et al.  The Impact of Conjugate Pneumococcal Vaccination on Routine Childhood Vaccination and Primary Care Use in 2 Counties , 2006, Pediatrics.

[16]  U. Kotagal,et al.  Combining evidence and diffusion of innovation theory to enhance influenza immunization. , 2006, Joint Commission journal on quality and patient safety.

[17]  C. Bridges,et al.  The underrecognized burden of influenza in young children. , 2006, The New England journal of medicine.

[18]  M. Gusic,et al.  Improving influenza vaccination rates for children through year-round scheduling. , 2006, Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association.

[19]  C. Bridges,et al.  Influenza Vaccination of Health-Care Personnel Recommendations of the Healthcare Infection Control Practices Advisory Committee ( HICPAC ) and the Advisory Committee on Immunization Practices ( ACIP ) , 2006 .

[20]  W. Schaffner,et al.  Influenza Vaccinations of Young Children Increased With Media Coverage in 2003 , 2006, Pediatrics.

[21]  M. Mufson,et al.  Standing Orders in an Ambulatory Setting Increases Influenza Vaccine Usage in Older People , 2005, Journal of the American Geriatrics Society.

[22]  L. Crane,et al.  Implementation of Universal Influenza Immunization Recommendations for Healthy Young Children: Results of a Randomized, Controlled Trial With Registry-Based Recall , 2005, Pediatrics.

[23]  B. Eser,et al.  Investigation of anti-Toxoplasma gondii antibodies in patients with neoplasia. , 2004, Journal of medical microbiology.

[24]  Malbea A Lapete,et al.  Prevention and Control of Influenza Recommendations of the Advisory Committee on Immunization Practices ( ACIP ) , 2004 .

[25]  T. Lieu,et al.  Incidence of outpatient visits and hospitalizations related to influenza in infants and young children. , 2004, Pediatrics.

[26]  J. Gerberding,et al.  Morbidity and Mortality Weekly Report Inside: Continuing Education Examination Applying Public Health Strategies to Primary Immunodeficiency Diseases a Potential Approach to Genetic Disorders Centers for Disease Control and Prevention Epidemiology Program Office Recommendations and Reports 1 Applyin , 2022 .

[27]  S. Humiston,et al.  Potential burden of universal influenza vaccination of young children on visits to primary care practices. , 2003, Pediatrics.

[28]  Ben Schwartz,et al.  Time spent by primary care practices on pediatric influenza vaccination visits: implications for universal influenza vaccination. , 2003, Archives of pediatrics & adolescent medicine.

[29]  P. Szilagyi,et al.  Physician perspectives regarding pneumococcal conjugate vaccine. , 2002, Pediatrics.

[30]  S. Humiston,et al.  Reducing geographic, racial, and ethnic disparities in childhood immunization rates by using reminder/recall interventions in urban primary care practices. , 2002, Pediatrics.

[31]  T. Liou,et al.  Influenza vaccination coverage level at a cystic fibrosis center. , 2002, Pediatrics.

[32]  K. Edwards,et al.  Burden of interpandemic influenza in children younger than 5 years: a 25-year prospective study. , 2002, The Journal of infectious diseases.

[33]  M. Gaglani,et al.  A computerized reminder strategy is effective for annual influenza immunization of children with asthma or reactive airway disease , 2001, The Pediatric infectious disease journal.

[34]  M. Wasserman,et al.  Guide to community preventive services: state and local opportunities for tobacco use reduction. , 2001, American journal of preventive medicine.

[35]  S. Humiston,et al.  Impact of vaccine financing on vaccinations delivered by health department clinics. , 2000, American journal of public health.

[36]  R. Davis,et al.  Influenza and the rates of hospitalization for respiratory disease among infants and young children. , 2000, The New England journal of medicine.

[37]  E F Mitchel,et al.  The effect of influenza on hospitalizations, outpatient visits, and courses of antibiotics in children. , 2000, The New England journal of medicine.

[38]  C. Connors,et al.  Universal hepatitis B vaccination: hospital factors influencing first‐dose uptake for neonates in Darwin , 1998, Australian and New Zealand journal of public health.

[39]  C. Randolph,et al.  IMPROVING INFLUENZA VACCINATION RATES IN CHILDREN WITH ASTHMA: A TEST OF A COMPUTERIZED REMINDER SYSTEM AND AN ANALYSIS OF FACTORS PREDICTING VACCINATION COMPLIANCE , 1994, Pediatrics.

[40]  S. Humiston,et al.  Immunization practices of primary care practitioners and their relation to immunization levels. , 1994, Archives of pediatrics & adolescent medicine.

[41]  L E Rodewald,et al.  Improving influenza vaccination rates in children with asthma: a test of a computerized reminder system and an analysis of factors predicting vaccination compliance. , 1992, Pediatrics.

[42]  Stanley Lemeshow,et al.  Sampling of Populations: Methods and Applications , 1991 .

[43]  K. Margolis,et al.  Organizational strategies to improve influenza vaccine delivery. A standing order in a general medicine clinic. , 1988, Archives of internal medicine.

[44]  Jennifer Spaeth,et al.  Task Force on Community Preventive Services , 2009 .

[45]  N. Cox,et al.  Prevention and Control of Influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). , 2006, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[46]  J. Gerberding,et al.  Childhood influenza vaccination coverage--United States, 2004-05 influenza season. , 2006, MMWR. Morbidity and mortality weekly report.

[47]  Edward J. Sondik,et al.  Estimated influenza vaccination coverage among adults and children--United States, September 1, 2004-January 31, 2005. , 2005, MMWR. Morbidity and mortality weekly report.

[48]  Rapid assessment of influenza vaccination coverage among HMO members--northern California influenza seasons, 2001-02 through 2004-05. , 2005, MMWR. Morbidity and mortality weekly report.

[49]  Experiences with obtaining influenza vaccination among persons in priority groups during a vaccine shortage--United States, October-November, 2004. , 2004, MMWR. Morbidity and mortality weekly report.

[50]  Estimated influenza vaccination coverage among adults and children--United States, September 1-November 30, 2004. , 2004, MMWR. Morbidity and mortality weekly report.

[51]  Jennifer Barrow,et al.  Identification and recall of children with chronic medical conditions for influenza vaccination. , 2004, Pediatrics.

[52]  Updated interim influenza vaccination recommendations--2004-05 influenza season. , 2004, MMWR. Morbidity and mortality weekly report.

[53]  D. Snider,et al.  Childhood influenza-vaccination coverage--United States, 2002-03 influenza season. , 2004, MMWR. Morbidity and mortality weekly report.

[54]  Acip.  Prevention and control of influenza : recommendations of the Advisory Committee on Immunization Practices (ACIP) , 2004 .

[55]  L E Rodewald,et al.  Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults. The Task Force on Community Preventive Services. , 2000, American journal of preventive medicine.

[56]  Abigail Shefer,et al.  Reviews of evidence regarding interventions to improve vaccination coverage in children, adolescents, and adults 1 2 , 2000 .