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Clinics, EDs miss many flu vaccination opportunities

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Universal pediatric influenza vaccination faces roadblocks


Dr. Burt Lesnick

Dr. Burt Lesnick, FCCP, comments: The federally funded Vaccine for Children program provides free influenza vaccine in most states. However, many states require that a specialist take shipment and administer all the childhood vaccines offered in order to get the influenza vaccine. Such roadblocks are common and need to be removed if we are to achieve our goal of universal pediatric influenza vaccination. Among elderly individuals most at risk, the evolving concept of a medical home should support vaccination. However, if primary care physicians believe that specialists giving influenza vaccine undercuts the medical home concept, then the patient loses. A medical home with a good medical neighbor may be the best combination."

Burt Lesnick, M.D., FCCP, is currently a practicing pediatric pulmonologist in Atlanta, Georgia, where he is the assistant managing partner of Georgia Pediatric Pulmonology Associates, a group of 14 pediatric pulmonologists. He also serves as President of the Medical Staff for Children's Healthcare of Atlanta.


 

References

LAKE BUENA VISTA, FLA. – Nearly 44% of incompletely vaccinated inpatients with influenza had a missed opportunity for vaccination, according to a chart review at Children’s Hospital Colorado.

Among 197 such children admitted with confirmed influenza in 2010-2014, 86 (44%) had a total of 507 medical visits during which influenza vaccine was available, Dr. Suchitra Rao of the University of Colorado, Denver, reported in a poster at the Pediatric Hospital Medicine 2014 meeting.

© Sean Locke/iStockphoto.com

Nearly 44% of inpatients incompletely vaccinated for influenza had a missed opportunity for proper vaccination.

The majority of patients with missed opportunity visits were considered high risk for severe complications from influenza from factors such as age younger than 2 years, immunosuppression, pregnancy, or an underlying chronic pulmonary, cardiovascular, renal, hepatic, neurological, hematologic, or metabolic disorder, Dr. Rao reported.

The bulk of missed opportunity visits occurred during September, October, and November (20%-23% each month) prior to onset of the influenza season, with declining percentages taking place between December and April. Most of the visits (45%) occurred at specialty clinics, followed by the emergency department or urgent care setting (22%).

"Subspecialty outpatient visits provide an excellent opportunity for influenza vaccination because they target high-risk patients and they represent the highest proportion of missed opportunities for vaccination," Dr. Rao and her colleagues wrote. Future analyses will explore independent risk factors for missed opportunities, and identify differences in visit characteristic for high vs. low risk groups, they noted.

The Pediatric Hospital Medicine 2014 meeting was sponsored by the Society of Hospital Medicine, the American Academy of Pediatrics, the AAP Section on Hospital Medicine, and the Academic Pediatric Association.

The authors reported having no relevant financial disclosures.

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