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Improving influenza vaccination coverage in the pediatric asthma population: the case for combined methodologies
1Medical Informatics, Portland VA Medical Center, Portland, Oregon, and Department of Medical Epidemiology and Clinical Informatics, Oregon Health Sciences University, Portland, Oregon.
Insights
Annual influenza vaccination is recommended for children with asthma, but rates remain low, particularly in low-income populations. Combining multiple strategies may help achieve higher vaccination goals.
Area of Science:
- Pediatric Pulmonology
- Public Health
- Immunization Practices
Background:
- Annual influenza vaccination is recommended for pediatric asthma patients due to high risk of complications.
- Influenza vaccination rates in children with asthma are suboptimal, especially among underserved populations.
- Existing interventions have not met Healthy People 2020 vaccination targets.
Purpose of the Study:
- To review interventions aimed at increasing influenza vaccination rates in pediatric asthma patients.
- To identify strategies that could help achieve national vaccination goals for this vulnerable group.
Main Methods:
- Review of multiple intervention strategies, including educational, informational technology, and legislative approaches.
- Analysis of the effectiveness of various interventions in improving pediatric asthma patient immunization.
- Consideration of combined methodologies and access to care improvements.
Main Results:
- Various interventions (recall, education, IT, legislative) show some effectiveness.
- No single intervention or combination has yet achieved the 80% Healthy People 2020 goal.
- Low-income status is associated with lower vaccination rates.
Conclusions:
- Achieving high influenza vaccination rates in pediatric asthma patients requires multifaceted approaches.
- Improving access to care for underserved populations is crucial for increasing immunization coverage.
- A combination of evidence-based strategies may be necessary to meet public health vaccination targets.
Abstract:
The Advisory Committee on Immunization Practices recommends annual influenza vaccine for pediatric asthma patients. Despite considerable risk for influenza complications in pediatric asthma patients, including hospitalization and death, influenza vaccination among children with asthma remains low, especially among low-income pediatric asthma patients. Multiple interventions have been attempted to increase immunization in the pediatric asthma population, including recall and reminders, parent/patient education, and physician education. More recently, information technology methods have been employed, including electronic alerts and computerized physician order entry/clinical decision support interventions. Each of these interventions, as well as a recent legislative intervention, has evidence of effectiveness, but none achieved the Healthy People 2020 vaccination goals of 80 percent for this population. This goal may be achievable with a combination of these methodologies and strategies that increase access to care for underserved patients.
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