Improving Influenza Vaccination in the Pediatric Emergency Department

Area of Science:

• Pediatrics
• Public Health
• Infectious Disease Prevention

Background:

• Annual influenza vaccination is recommended for individuals 6 months and older by the American Academy of Pediatrics.
• A local pediatric emergency department (ED) faced lower-than-average influenza vaccination rates in 2019.
• The study addressed the need to enhance influenza vaccination coverage in a pediatric ED setting.

Purpose of the Study:

• To increase influenza vaccination screening from 53% to 95% within the pediatric ED.
• To improve influenza vaccine administration rates from 48% to 58% by March 2023.
• To evaluate an intervention model for influenza vaccination delivery in a pediatric emergency department.

Main Methods:

• The study included patients over 6 months old discharged from the ED, excluding those requiring resuscitation or transfer.
• Interventions involved implementing triage screening questions and electronic health record alerts.
• Data were collected over three influenza seasons, with a baseline and poststudy period, analyzed using Shewhart charts.

Main Results:

• Initial implementation achieved 98% screening and 70% vaccine administration in the first season.
• Screening rates decreased to 79-86% and immunization rates fell below baseline (37-50%) in subsequent seasons.
• Parental refusal rates remained stable, but provider discontinuation of vaccination increased over time.

Conclusions:

• An ED-based influenza vaccination delivery model can be effective with integrated triage screening.
• Consistent ordering by ED-based staff and effective EHR utilization are crucial for success.
• Sustained efforts are necessary to maintain high vaccination rates in pediatric emergency departments.