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Tuesday, October 19, 2004 - 1:35 PM
1

Can High Rates of Influenza Immunization be Achieved in Healthy Young Children? Results of a RCT Using Registry-based Recall

Allison Kempe1, Matthew F. Daley1, Jennifer Barrow1, Nellie Hester1, Brenda L. Beaty1, Vijayalaxmi Chandramouli2, Kellyn Pearson1, Norma J. Allred3, Lori Crane4, and Stephen Berman1. (1) Dept. of Pediatrics, Univ. of Colo. HSC, Children's Outcomes Research Program, The Children's Hospital, 1056 E. 19th Avenue, Denver, CO, USA, (2) Children's Outcomes Research Program, The Children's Hospital, Denver, CO, USA, (3) Immunization Services Division, HSREB, National Immunization Program, CDC, 1600 Clifton Rd, ND, Mailstop E-52, Atlanta, GA, USA, (4) Department of Preventive Medicine and Biometrics, University of Colorado HSC, 4200 E. 9th Avenue, C245, Denver, CO, USA


BACKGROUND:
During 2003-2004 the ACIP encouraged flu immunization (Iz) in children 6-23 months.

OBJECTIVE:
1) To assess the maximum flu Iz rate that can be achieved in healthy children 6-21 months in private practice settings and 2) to evaluate the efficacy of registry-based recall for flu.

METHOD:
The study was conducted in 5 pediatric practices. Healthy children 6-21 months were selected (N=5193) and randomized to an intervention (I; n=2595) group that received up to 3 recall letters or to a control (C; n=2598) group that received usual care. The primary outcome was receipt of one or more flu Iz.

RESULT:
Iz rates in the I groups in the 5 practices were 75.9%, 75.4%, 68.1%, 55.6% and 44.3% by 2/29/04. Overall, 62.4% of I vs. 58.0% of C were immunized (4.4% absolute increase, p=0.001), with absolute % increases over C ranging by practice from 1.0% (p=NS, I vs C) to 9.1% (p=0.002, I vs C). However, before the epidemic (publicity beginning 11/15/03) absolute % increases over C ranged from 5.1% to 15.3% and were 9.6% overall (p<0.0001, I vs C). Before 11/15, significant effects of recall were seen both for children 12-21 months (10.4% increase over C, p<0.0001) and 6-11 months (8.1% increase over C, p=<0.001), but by 2/29 significant effects of recall were seen only in the older age group (6.2% increase over C, p<0.001).

CONCLUSION:
Although media coverage regarding the epidemic blunted the effect of registry-based recall, it was still effective in raising rates before the epidemic hit.

LEARNING OBJECTIVES:
Able to identify the effectiveness of using an immunization registry to do a recall for influenza vaccinations in children 6-23 mo of age.

[ Recorded presentation ]   Recorded presentation

See more of Using Immunization Registries for Influenza and Pneumococcal Recall Efforts and to Monitor Provider Adherence to Vaccine Recommendations
See more of The 2004 Immunization Registry Conference