Improving Influenza Vaccination Rates in an Underserved Primary Care Clinic Using a Simple Educational Tool

Influenza is a preventable communicable illness that has a significant impact on people of all ages. In 2018, it was estimated that 80 000 people died of influenza-related illnesses. In the 2018-2019 influenza season, only 34.9% of individuals in the 18 to 49 years age group received the influenza vaccine. Despite the low vaccination rate for influenza, the vaccine has multiple evidence-based benefits that demonstrate the importance of improving its uptake among adults. According to data from the Centers for Disease Control and Prevention (CDC), the vaccine prevented around "6.2 million influenza illnesses, 3.2 million influenza-associated medical visits 91 000 influenza-associated hospitalizations, and 5700 influenza-associated deaths" in the 2017-2018 influenza season. In a suburban family medicine clinic, a primary care provider (PCP) observed that greater than 50% of adult patients in his family medicine practice declined influenza vaccine when offered during the 2018-2019 season compared with the site rate of 43.4% and the department rate of 47.9%.

The goal of this project was to educate patients who initially decline the vaccine to agree to receive the vaccine and to increase the percentage of patients who get an influenza vaccine from 43.4% to 50% in adult patients at a suburban primary care clinic by having them read the CDC document and asking them after they read the document whether they would like to receive the vaccine. From October 1, 2018, to February 28, 2019, adult patients in a primary care clinic were asked whether they wanted to receive the influenza vaccination and responses were recorded. During this time, 589 patients were questioned, with 56% (n = 330) answering no, or 43% of patients receiving the influenza vaccination.

In total, 658 patients were offered the flu shot during the intervention period, representing 27.7% of the patients seen in this clinic. While there was some monthly variation, the PCP was able improve the percentage of patients receiving the influenza vaccination from 43% to 60.9% with this simple educational intervention. The overall clinic rate for this time frame increased from 56.6% to 58.2%.

This simple intervention was effective in improving influenza vaccine rates for one provider in a suburban safety-net clinic. It added minimal workload to the provider, and the intervention is easily replicable in other settings.