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Increasing COVID-19 Vaccination Rates for Children With Sickle Cell Disease
Adam P Yan1, Natasha M Archer1, Dianne Arnold2
1Dana-Farber/Boston Children's Cancer and Blood Disorders Center and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
Insights
COVID-19 vaccination rates for children with sickle cell disease (SCD) increased through targeted interventions. Addressing misinformation and improving access are key to boosting vaccine uptake in this vulnerable group.
Area of Science:
- Pediatric Health
- Infectious Disease Prevention
- Public Health Interventions
Background:
- Children with sickle cell disease (SCD) are a priority group for COVID-19 vaccination due to increased health risks.
- A quality improvement project aimed to increase the proportion of children with SCD receiving at least two COVID-19 vaccine doses to over 70% by June 2022.
Purpose of the Study:
- To implement and evaluate strategies for increasing COVID-19 vaccination rates among children with sickle cell disease.
- To assess the effectiveness of interventions focused on patient education, provider awareness, and vaccine accessibility.
Main Methods:
- Utilized the Model for Improvement framework with three plan-do-study-act cycles.
- Biweekly assessment of COVID-19 vaccination rates in children with SCD.
- Employed interrupted time series analysis to model implementation rates and statistical process control charts for tracking changes.
Main Results:
- Overall vaccination rates for children with SCD increased from 33% to 64% during the intervention period (February-June 2022).
- Mean vaccination rate per 2-week period rose significantly, with 10 patients booking vaccines after outreach calls and 40% viewing an educational video.
- Missed clinic appointments remained stable, indicating interventions did not negatively impact routine care access.
Conclusions:
- Targeted interventions addressing misinformation and improving vaccine access can enhance COVID-19 vaccination rates in children with SCD.
- Despite improvements, a substantial proportion of children with SCD remain unvaccinated, necessitating further interventions.
- The project demonstrated a higher-than-predicted vaccination rate for SCD patients compared to the general population.
Background:
The COVID-19 vaccine is important for children with sickle cell disease (SCD). This quality improvement project's objective was to increase the proportion of children with SCD receiving ≥2 COVID-19 vaccine doses to ≥70% by June 2022.
Methods:
We used the Model for Improvement framework. We assessed COVID-19 vaccination rates biweekly. Three plan-do-study-act cycles focusing on patient education, provider awareness, and access were performed. Process measures included the outcome of outreach calls and educational video views. Missed clinic appointments was our balancing measure. Line graphs and statistical process control charts were used to track changes. Interrupted time series was used to model implementation rates while accounting for preexisting trends.
Results:
A total of 243 patients were included. During the preintervention (September 2021-January 2022) and intervention periods (February 2022-June 2022), overall vaccination rates increased from 33% to 41% and 41% to 64%, respectively. Mean vaccination rate in eligible children in each 2-week period increased from 2.1% to 7.2%. The achieved vaccination rate was 11% greater than predicted for patients with SCD. For the general population the achieved vaccination rate was 23% lower than predicted. The proportion of missed visits did not change (9.0% vs. 9.6%). During outreach calls, 10 patients (13.5%) booked a vaccine. Forty percent of patients watched the promotional video.
Conclusions:
A significant number of patients with SCD are not vaccinated against COVID-19. Targeting misinformation and improving vaccine access aided in increasing vaccination. Additional interventions are needed as a large number of patients remain unvaccinated.
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