BACKGROUND:
Many patients with chronic illnesses receive most of their medical care through specialists. Specialists traditionally have not had an important role in either promoting or providing immunizations. Lack of specialty involvement in adult immunizations represents a missed opportunity.

OBJECTIVE:
To determine whether the specialist can be effective in promoting immunizations in adults.

METHOD:
This is a prospective, randomized study of adults presenting to a university otolaryngology clinic. Through the use of a survey, knowledge base and level of immunization with respect to adult requirements were assessed. Patients were randomized into two groups: Group 1 was offered sources of further information relevant to access to immunizations and Group 2 was not. A follow-up survey was conducted three months later to determine if Group 1 had used the information proactively to improve immunization status.

RESULT:
Forty-seven patients completed the survey in August, 2002. There were 22 patients in Group 1 and 25 patients in Group 2. There was no statistical difference in the knowledge base of both groups. In the initial comparison, immunization rates for influenza vaccine and pneumococcal vaccine were almost identical. On the follow-up survey, members of Group 1, who had the availability of sources of immunization, had not improved their immunization rates, as only one additional patient was immunized. The rates essentially remained the same (p=1).

CONCLUSION:
Although this is a small study, it suggests that simply providing information about access does not increase the rate of immunization. This suggests the need for more active involvement by specialists, such as offering immunizations to patients in the specialist's office as a part of the patient's comprehensive care.

LEARNING OBJECTIVES:
To elucidate the role of the specialist in increasing immunization rates in the adult population.