KEYWORD1:
Disease Prevention, Immunizations

BACKGROUND:
The target populations for influenza and pneumococcal immunizations are similar, but influenza and pneumococcal rates are 69% and 49% respectively. Influenza clinics have been institutionalized due to the need for annual vaccination, but concomitant administration of pneumococcal vaccine at community-based clinics has not been widely adapted.

OBJECTIVE:
To determine if a vaccine recommendation card for pneumococcal vaccine provided to flu clinic attendees prompts the primary care provider to administer pneumococcal vaccine to susceptible clients.

METHOD:
Influenza vaccine recipients at the 2001-2002 community-based clinics were screened for pneumococcal vaccine by questionnaire. The first 3,000 vaccine recipients who self-identified as needing pneumococcal vaccine were given a numbered vaccine administration card to take to their physician. The card instructed the provider to assess the patient for pneumococcal vaccination, document vaccination outcome on the card, and mail it back to the Philadelphia health department.

RESULT:
Of 3,000 cards distributed, outcome information was available on 4% (125/3,000). Of those, 72% (91/125) took the card to a doctor; of those 91 patients 63% (57/91) were eligible for vaccine and 66% of eligible patients (38/57) received pneumococcal vaccine.

CONCLUSION:
Feedback was documented on 4% of the vaccine record cards. Distributing cards for patients to take to their providers is not an effective intervention in increasing pneumococcal vaccine assessment and administration. However, when the card was presented to a physician, the majority of eligible patients received pneumococcal vaccine. Finding alternative methods to prompt physicians to assess and administer pneumococcal vaccine to susceptible patients are needed.
LEARNINGOBJECTIVES:
1. Identify the purpose of the vaccine administration record card. 2. Describe two outcomes of the intervention. 3. State two reasons why the intervention was not effective.