Related Experiment Video
Updated: Jul 18, 2026
An Optimized Hemagglutination Inhibition (HI) Assay to Quantify Influenza-specific Antibody Titers
Published on: December 1, 2017
Improving influenza vaccination rates of high-risk inner-city children over 2 intervention years
Richard K Zimmerman1, Alejandro Hoberman, Mary Patricia Nowalk
1Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, 3518 Fifth Ave, Pittsburgh, PA 15261, USA.
Insights
Tailored interventions modestly increased influenza immunization rates in high-risk children over two years. This strategy showed promise, especially in faith-based practices, for improving vaccination coverage.
Area of Science:
- Pediatrics
- Public Health
- Immunization
Background:
- Influenza vaccination rates in high-risk children remain low.
- Limited data exist on effective, long-term strategies to increase childhood immunization rates.
- Inner-city health centers face challenges in achieving optimal vaccination coverage.
Purpose of the Study:
- To evaluate the effectiveness of tailored, site-specific interventions in improving influenza immunization rates among high-risk children.
- To assess the impact of these interventions over a two-year period in inner-city health centers.
- To identify specific practice types that benefit most from targeted immunization strategies.
Main Methods:
- A before-after trial was conducted in five inner-city health centers.
- Interventions included standing orders, patient/clinician reminders, and educational materials.
- Vaccination rates were compared pre-intervention, during intervention years 1 and 2, and with a comparison site.
Main Results:
- Influenza vaccination rates increased from 10.4% at baseline to 18.7% by year 2 (P <.001).
- Faith-based practices achieved rates as high as 31%.
- Increases were observed across all demographics, with significantly greater improvement in intervention sites (8.3%) versus the comparison site (0.7%).
Conclusions:
- Tailored interventions can modestly improve influenza vaccination rates in high-risk, low-income children over two years.
- The strategy is recommended for faith-based practices and single-site residencies.
- Further research is needed for multisite practices and to achieve higher vaccination coverage levels.
Purpose:
Influenza immunization rates among children with high-risk medical conditions are disappointingly low, and relatively few data are available on raising rates, particularly over 2 years. We wanted to determine whether interventions tailored to individual practice sites improve influenza immunization rates among high-risk children in inner-city health centers over 2 years.
Method:
A before-after trial to improve influenza immunization of children was conducted at 5 inner-city health centers (residencies and faith-based). Sites selected interventions from a menu (eg, standing orders, patient and clinician reminders, education) proved to increase vaccination rates, which were directed at children aged 2 to 17 years with high-risk medical conditions. Intervention influenza vaccination rates and 1 and 2 years were compared with those of the preintervention year (2001-2002) and of a comparison site.
Results:
Influenza vaccination rates improved modestly from baseline (10.4%) to 13.1% during intervention year 1 and to 18.7% during intervention year 2 (P <.001), with rates reaching 31% in faith-based practices. Rates increased in all racial and age-groups and in Medicaid-insured children. The increase in rates was significantly greater in intervention health centers (8.3%) than in the comparison health center (0.7%; P <.001). In regression analyses that controlled for demographic factors, vaccination status was associated with intervention year 1 (odds ratio [OR], 1.9; 95% confidence interval [CI], 1.6-2.2) and with intervention year 2 (OR, 2.8; 95% CI, 2.3-3.4), as well as with practice type. Adolescents had lower vaccination rates than children 2 to 6 years old (OR, 0.6; 95% CI, 0.5-0.7).
Conclusions:
Tailored interventions selected from a menu of interventions modestly increased influenza vaccination rates over 2 years at health centers serving children from low-income families. We recommend this strategy for faith-based practices and residencies with 1 practice site, but further research is needed on multisite practices and to achieve higher influenza vaccination rates.
Related Concept Videos
01:51Vaccinations
01:30Community Based Intervention
Foundations of Community Mental Health Programs
Central to the success of community-based interventions is the...
01:27Influenza
01:29Respiratory Syncytial Virus Disease
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.