Seasonal Influenza Vaccination for Adults: Current Practice and Future Possibilities

Background:Seasonal influenza vaccine is recommended for all adults ≥ 50 years and those <50 with chronic health conditions.  Less than half of the adults for which seasonal influenza vaccine is recommended receive the vaccine.  Little is known about provider willingness to collaborate with community groups to improve delivery of seasonal influenza vaccine to adults.

Objectives:To assess among general internists (GIM) and family medicine (FM) physicians regarding seasonal influenza vaccine for adults: 1) current vaccination practices 2) willingness to collaborate with other entities to deliver vaccine and 3) barriers to collaboration.

Methods:A national survey of 432 GIM and 424 FM physicians conducted July-October 2009.

Results:Response rates were 78% (337/432) for GIM and 70% (298/424) for FM.  Most providers reported routinely vaccinating adults ≥65 (96%) and adults 19-49 with chronic medical conditions (86%); only 58% reported routinely vaccinating healthy adults 50-64.  Few providers reported currently collaborating with public health departments (14%) or pharmacies (5%) to vaccinate patients.  Most providers reported willingness to refer sub-groups of patients to receive vaccine at public vaccination clinics or pharmacies (79%), participate with public health entities to set up community vaccination clinics (76%), and setup joint vaccination clinics with other practices (69%). The most frequently reported significant barriers to collaboration included concern that records of vaccine given outside the office would not be transferred to the office (24%), the time and effort it would take to collaborate (21%), and difficulty estimating the amount of vaccine to order (17%).

Conclusions:Although providers report routinely vaccinating the vast majority of their elderly patients or those with chronic conditions, fewer report routinely vaccinating healthy adults 50-64.  Providers are not routinely collaborating with community groups to deliver influenza vaccine, but the majority are willing to do so.  Successful collaboration will require reliable record transfer and provisions to protect providers from being left with extra vaccine supplies.