Why Do Today What You Can Do in February? Changing Doctors' Minds about Extending Influenza Vaccination Into Late-Season

Background: With the expansion of influenza vaccine recommendations and increased vaccine availability, provider and public health capacity will be tested. Since seasonal influenza disease most commonly peaks during February or March in San Diego, expanding vaccination into February is a viable strategy to increase capacity. San Diego Influenza Coverage Extension is a two-year project aimed at identifying patient perceptions and provider practices about late-season flu vaccination and working with clinics to extend influenza season into February and March.

Objectives: To collect comprehensive information about immunization practices. To analyze key informant interview data to characterize a clinic’s ability to extend flu season. To design personalized interventions for clinics to improve influenza coverage rates.

Methods: Research staff conducted Key Informant Interviews (KII) with 37 clinic staff from 16 clinics probing into strategies for vaccination during influenza season. Results were coded to characterize the clinic as adhering to “few”, “some”, or “many” of the immunization standards. The KIIs for the clinics in the intervention groups were reviewed and personalized interventions based on national immunization standards were created for each clinic.

Results: On average, clinics were implementing less than half of the immunization standards which would increase influenza coverage rates. Research staff presented personalized handbooks with results of patient surveys and chart reviews to key clinic staff and described strategies the clinic could implement to increase coverage rates and decrease missed opportunity rates. Coverage rates were lower and missed opportunity rates higher than clinics expected. Clinics perceived patient interest in late-season vaccination to be lower than patient-reported interest.

Conclusions: While most clinics reported having a high interest in providing influenza vaccine to all patients, they lacked the strategies necessary to do so. Based on patient interest, clinics could successfully execute late-season vaccination campaigns. Clinics could increase coverage rates by promoting influenza vaccine during late-season.