BACKGROUND:
Influenza vaccination effectively reduces influenza-related morbidity in children, but is underutilized. Many influenza vaccine-targeted children seek care in an emergency department during the fall/winter influenza vaccination period.

OBJECTIVE:
To assess the effectiveness of a pediatric emergency department-based influenza vaccination program.

METHOD:
Influenza vaccine-targeted children and their families were enrolled from among patients seeking emergency care at Strong Memorial Hospital in Rochester, NY, during fall/winter 2002. Eligible families were those with a member at “increased risk” for influenza related morbidity or mortality as defined by CDC guidelines, or those with a child less than or equal to 23 months of age.
We randomized participating families to the ”vaccine offered” group or the “education only” group. We educated both groups with regards to influenza illness, risks and benefits of influenza vaccination, and means of receiving influenza vaccination outside of the study. We then offered influenza vaccination to those in the “vaccine offered” group. After the end of influenza season we obtained telephone report of each subject’s vaccination status.

RESULT:
437 subjects completed the study: 238 subjects in “vaccine offered” group, and 199 subjects in “education only” group. At the end of influenza season there was a greater likelihood of reporting having been vaccinated in the “vaccine offered” group than in the “education only group”. This was true for targeted children who presented as patients ( 57% vs. 36%) (OR 2.37, 95% CI (1.30,4.33) as well as for their accompanying adult and child family members (75% vs. 34%) (OR 5.79, 95% CI (3.15,10.71).

CONCLUSION:
A pediatric emergency department-based influenza vaccination program is an effective means of increasing influenza vaccination in targeted children and family members who use the emergency department during influenza vaccination season.

LEARNING OBJECTIVES:
Understand the potential benefits and limitations of a pediatric emergency department–based influenza vaccination program.