Interoffice Variability in the Delivery of Influenza Vaccine by US Pediatric Offices

Background: Limited data are available on the current use of influenza vaccines by US office-based pediatricians.

Objectives: To describe pediatric influenza vaccination behaviors and delivery in a geographically diverse sample of US pediatricians

Methods:  A prospective, observational study was conducted during the 2010-2011 influenza season. In total, 105 offices tracked vaccination-related activities and influenza vaccinations given by age group; data were collected every 2 weeks and entered into an electronic database from August 1 through March 31. Surveys at study start and completion captured patient population by age group and office demographics and characteristics. Vaccine coverage (percentage of children receiving ≥1 dose) and 2-dose compliance (percentage of children requiring 2 doses who received a second dose) were calculated for each study office. Data were analyzed with descriptive statistics.

Results: Significant office-level variability was observed in all outcomes. The median (range) overall coverage was 24% (2%-60%). By age group, coverage rates were 46% (2%-100%), 29% (2%-82%), 27% (2%-89%) and 13% (0%-68%) in those 6-23 months, 24-59 months, 5-8 years and 9-18 years, respectively. The 2-dose compliance in those who required 2 doses was 56% (11%-100%); 2-dose compliance by age group was 66% (11%-100%), 45% (0%-100%) and 38% (0%-100%) in children 6-23 months, 24-59 months, and 5-8 years of age, respectively. Median vaccine availability was 239 days (60-302 days). Most vaccines (40%; 0%-100%) were administered during routine health maintenance visits, followed by clinics during normal office hours (20%; 0%-100%), sick visits (15%; 0%-80%), and vaccine clinics outside normal office hours (0%; 0%-80%).

Conclusions:  Among pediatric offices there is substantial interoffice variation in the delivery of influenza vaccinations to children. A greater understanding of the techniques that pediatric offices employ to deliver influenza vaccine to children and identification of best practices could help to improve pediatric influenza vaccination rates. Sponsored by MedImmune, LLC.