Administering influenza vaccine in a Canadian emergency department: is there a role?

To determine the prevalence of influenza vaccination in patients who present to the emergency department (ED) who meet current guidelines for its use. To evaluate the feasibility of an ED-based program to provide influenza vaccine to at-risk patients.

A survey of ED patients and their family physicians, using a convenience sample.

Consecutive patients presenting to the emergency department of Prince George Regional Hospital, Prince George, BC, a regional hospital in Northern British Columbia, during designated shifts between Nov. 6, 1997, and Dec. 10, 1997.

Age, gender, family physician (FP), eligibility for influenza vaccine, vaccination status, willingness to receive vaccine in the ED, and FP methods for ensuring use of influenza vaccine.

935 patients were interviewed; 816 met study eligibility criteria. Of 214 patients eligible for influenza vaccine, 113 (52.8%) had not been vaccinated. Fifty-three (46.9%) agreed to vaccination, and 49 were vaccinated in the ED. A survey of the patients' FPs revealed that 85% used callback lists, but that only 49% of vaccine-eligible patients identified in the study were on a callback list. Positive associations were found between the presence of an FP and the likelihood of having been vaccinated (odds ratio [OR] = 8.8), being on a callback list and having been vaccinated (OR = 4.1), and age >64 and being on a callback list (OR = 2.1).

Up to 50% of patients eligible for influenza vaccine are not adequately immunized. Administering influenza vaccine in the ED is acceptable to patients and should reduce influenza rates in at-risk populations. There is a role for administering influenza vaccine in the ED.