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Evaluation of an Influenza Vaccination Program in the Pediatric Emergency Department
Amethyst Alayari1, Sonja I Ziniel2, Ethan Hawkins3
1Department of Pediatrics (Emergency Medicine), University of California San Diego and Rady Children's Hospital, San Diego, CA.
Insights
A standardized influenza vaccination program in pediatric emergency departments (EDs) significantly increased vaccine administration rates. This initiative particularly benefited minority and government-insured children, addressing health disparities.
Area of Science:
- Pediatric Emergency Medicine
- Public Health
- Vaccinology
Background:
- Influenza vaccination is crucial for preventing severe illness in children.
- Pediatric emergency departments (EDs) are key sites for reaching eligible children.
- Standardized programs can improve vaccine administration rates.
Purpose of the Study:
- To assess the impact of a standardized vaccination program on influenza vaccine administration in pediatric EDs.
- To evaluate the program's effectiveness in increasing vaccination coverage.
Main Methods:
- Retrospective study of children ≥6 months in pediatric EDs.
- Compared preintervention (2019-2020) and intervention (2020-2023) periods.
- Intervention included nursing education, standing orders, and EHR best practice advisories.
Main Results:
- The standardized program significantly increased the odds of influenza vaccination by 15.22 (95% CI: 12.39-18.70).
- Vaccination rates increased from 272 to 1892, 2141, and 755 during intervention seasons.
- Vaccinated children were more likely to be older, Black, Hispanic, publicly insured, and of lower triage acuity.
Conclusions:
- Standardized ED influenza vaccination programs effectively increase administration rates.
- These programs help reduce vaccine disparities among minority and government-insured children.
- The interventions are sustainable and can lessen the public health impact of influenza.
Objective:
To evaluate influenza vaccine administration rate among eligible patients in pediatric emergency departments (EDs) following the introduction of a standardized vaccination program.
Study Design:
We conducted a retrospective study of children ≥6 months of age evaluated in a tertiary care pediatric ED and 3 affiliated ED sites. Our preintervention period was September 2019 through April 2020, and intervention period was September 2020 through April 2023. Our intervention comprised nursing education, standing orders, and a best practice advisory in the electronic health record. Our primary outcome was administration of influenza vaccine in the ED.
Results:
There were 51 581 and 144 811 children in the preintervention and intervention periods with 64 705 and 172 021 ED encounters, respectively. The intervention increased the odds of vaccination by 15.22 (95% CI: 12.39-18.70), from 272 influenza vaccines in the preintervention period to 1892, 2141, and 755 in the intervention seasons (P < .001). During the intervention period, children who received influenza vaccines compared with those who did not were more likely to be older (median 8.5 years vs 5.8 years), of Black race (8.4% vs 7.2%) or multiple/other race (26.0% vs 19.8%), Hispanic ethnicity (46.0% vs 34.7%), with public insurance (64.3% vs 56.0%), and of lower acuity triage level 4 or 5 (64.2% vs 56.8%), P < .001 for all.
Conclusions:
Implementation of a standardized influenza vaccination program in the ED can increase vaccination rates, particularly among minority and government-insured children. These interventions can address vaccine disparities and are easily sustainable with potential to reduce the public health burden of influenza.
