Smaller Pediatric Offices Have Higher In-Office Influenza Vaccination Rates

Background: Efficient delivery of influenza vaccines by office-based providers is critical given that all eligible children 6 months and older are recommended for influenza vaccination and there is limited time in which to deliver the vaccine each year.

Objectives: To evaluate characteristics and activities that correlate with influenza vaccination coverage (receipt of at least 1 dose) in US pediatric offices

Methods:  A multi-year, observational study of US outpatient pediatric offices prospectively captured influenza vaccinations by age group and activities to increase vaccine uptake during the 2007–2008 through 2010–2011 influenza seasons. Offices were recruited from a random sample of the American Medical Association list of pediatricians. Vaccination coverage was calculated as the number of children vaccinated with at least 1 dose divided by the total number of children under the office’s care. For each season, office characteristics that were correlated with office-level coverage were evaluated qualitatively and with regression analyses.

Results:  Vaccination coverage for children 6 months to 18 years of age was assessed in 36, 76, 82, and 103 pediatric offices during the 2007–2008, 2008–2009, 2009–2010, and 2010–2011 influenza seasons, respectively. Across all 4 seasons, lower coverage rates were observed in offices with more children under their care; office-level vaccination coverage fell by 21% (P<0.001), 24% (P<0.001), 20% (P<0.001), and 24% (P<0.001) in each of the 4 study seasons, respectively, with each 10-fold increase in total patients. No other variable was similarly correlated with coverage.

Conclusions:  Larger offices appear to be disadvantaged in delivering influenza vaccine to their patients, perhaps due to less inherent “surge-capacity” during vaccination season. Larger offices should consider steps to enhance their vaccination efforts to overcome this barrier. Sponsored by MedImmune, LLC.