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Interventions Over 2 Years to Increase Influenza Vaccination of Children Aged 6-23 Months in Inner-City Family Health Centers

Richard K. Zimmerman1, Mary Patricia Nowalk1, Chyongchiou J. Lin2, and Feng-Shou Ko3. (1) Family Medicine & Clinical Epidemiology, University of Pittsburgh, 3518 Fifth Avenue, Pittsburgh, PA, USA, (2) Department of Radiation Oncology, University of Pittsburgh, 580 S Aiken Avenue, Suite 110, Pittsburgh, PA, USA, (3) Family Medicine and Clinical Epidemiology, University of Pittsburgh, 3518 5th Ave, Pittsburgh, PA, USA


Learning Objectives for this Presentation:
By the end of the presentation, participants will be able to understand the feasibility of influenza vaccination among children from low income families.

Background:
Due to high rates of hospitalization for influenza infections among very young children (<2 years), the Advisory Committee on Immunization Practices (ACIP) initiated new policy in 2002, which encouraged vaccination of healthy children ages 6-23 months against influenza.

Objectives:
To test the ability of tailored interventions to raise influenza immunization rates and assess the effect on timely receipt of other vaccines.

Methods:
We conducted a before/after trial over two years to increase influenza vaccination rates of patients 6 to 23 months old in five inner-city family health centers serving low-income children, with a sixth site as a concurrent control. Sites selected tailored interventions from strategies proven to increase vaccination rates.

Results:
Influenza vaccination rates improved significantly from a baseline of 4.7% to 24.7% in the first year and 36.6% in the second year, P<.001. The increase in rates was more in intervention sites than the control site (31.9% versus 25.7%, P =.02). In regression analyses for vaccination status that controlled for demographic factors, race was not a predictor of influenza vaccination but intervention year was associated with an Odds Ratio (OR) of 8.1 (95% confidence interval (CI) = 4.8-13.7) for the first intervention year and OR= 11.6 (95% CI = 7.1-18.8) for the second intervention year. Children vaccinated against influenza were more likely to have received DTaP 3 and MMR within two months of the recommended age than children not vaccinated against influenza (P<.001).

Conclusions:
These results show the feasibility of the recent recommendations to vaccinate children ages 6 to 23 months against influenza, at health centers serving low-income children. The addition of influenza vaccine was not associated with delayed receipt of other vaccines among these children.

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