Learning Objectives for this Presentation:
By the end of this presentation participants will be able to:
1. Describe changes in pediatric influenza immunization in Baltimore City, 1999-2004
2. Characterize changes by age, gender, race, season and practitioner participation
3. Appreciate the evolution of influenza immunization policy
4. Appreciate the utility of immunization registries to define trends in immunization


Background:
Influenza remains a major public health threat, causing 36,000 deaths and over 200,000 hospitalizations annually. Until recently, influenza immunization efforts have focused on adults. In 2002 CDC expanded indications to include healthy 6-23 month old children. The impact of this policy on practitioner behavior and immunization coverage in a metropolitan area may be assessed using an immunization registry.


Setting:
The Baltimore Immunization Registry (BIRP), developed in 1995, is a repository of pediatric immunization records from birth through high school. City ordinance mandates physician reporting of all immunizations administered to children under age 6 years.


Population:
All Vaccines for Children (VFC) providers; all immunization records in BIRP 1999-2004.


Project Description:
The total number of influenza vaccine doses administered 1999-2004 was tallied and sub-grouped by age.The percent of vaccine administered by month was examined. Immunization by gender and by race was assessed for 2003 and 2004. VFC provider participation 1999-2004 was documented.


Results/Lessons Learned:
From 2002-2004, pediatric influenza immunization demonstrated a sustained rise, especially for the < 12 month olds (2% to 13% of cohort) and those between 1 and 2 years (3% to 12% of cohort).
83% of vaccine was used in October-December. Administration continued year-round except for April-August. VFC provider participation increased from 29% in 1999 to 70% in 2004. BIRP figures for gender and race correlate well with Census data. Suggested reasons for rapid adoption of new immunization policy include: well-educated, pro-active practitioners; outreach efforts by the Baltimore City Health Department and Maryland VFC Program to educate providers; and effective Medicaid enrollment.