In the United States, annual influenza vaccine is now recommended for all children 6 months through 18 years of age. This 2-year observational study of US outpatient pediatricians' offices captured office demographics and characteristics, recorded all influenza vaccinations administered and vaccination-related activities during the influenza season, and correlated office characteristics and activities associated with increased vaccine uptake. Offices generally offered the influenza vaccine from September through February and March; however, approximately 80% of vaccinations occurred in October through December. In 2008 compared with 2007, offices administered the vaccine earlier and later into the season. Estimated in-office rates of first-dose administration, 2-dose compliance, and use of the intranasal vaccine also increased. Qualitative analyses suggest that increased firstdose administration and 2-dose compliance rates are associated with smaller office size and a greater duration of vaccine availability, respectively, during both seasons.
the VFC program is critical to ensuring financially vulnerable children have access to vaccination. Manufacturers, distributors, and public health officials should deliver VFC influenza vaccine to providers as quickly as possible. Pediatric healthcare providers should increase efforts to vaccinate all populations, especially the VFC population, in later months.
During the 2010-2011 US influenza season, 105 pediatric and 13 family practice offices participated in a prospective observational study of in-office influenza vaccination of children. Office characteristics, influenza vaccinations, and vaccination-related activities were reported. Among pediatric offices, first dose vaccination rates (2% to 60%), 2-dose compliance (11% to 100%), the duration of vaccine availability (60-302 days), and office visit type (well vs sick vs clinic) used for vaccinations varied greatly. Pediatric offices had higher vaccination coverage than family practice offices, offered vaccine longer, and administered more vaccinations during sick visits. Smaller offices and higher staff vaccination rates were associated with higher vaccination coverage. Smaller offices and video reminders in waiting rooms were associated with enhanced 2-dose compliance among children younger than 9 years. A greater understanding of interoffice variability in influenza vaccine delivery by US pediatric providers should allow for the creation of more effective strategies to improve pediatric influenza vaccination rates.
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