Additional Visit Burden for Universal Influenza Vaccination of US School-Aged Children and Adolescents

Rand, Cynthia M.; Szilâgyi, Peter G.; Yoo, Byung Kwang; Auinger, Peggy; Albertin, Christina; Coleman, Margaret S.

doi:10.1001/archpedi.162.11.1048

Cited by 47 publications

(30 citation statements)

References 43 publications

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“…Among children aged 9 to 18 years, at least 75% would need 1 extra visit. 39 To be maximally effective and avoid missed opportunities to prevent early season infections, vaccination should occur as early as possible, beginning as early as September. Strategies to reduce the burden of extra visits include providing vaccination at all medical visits during the influenza season, and extending the vaccination season through February to increase coverage during the usual peak month of transmission, or who need second doses.…”

Section: Immunization Program Issuesmentioning

confidence: 99%

Expanding the Recommendations for Annual Influenza Vaccination to School-Age Children in the United States

et al. 2012

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BACKGROUND Despite long-standing recommendations to vaccinate children who have underlying chronic medical conditions or who are contacts of high-risk persons, vaccination coverage among school-age children remains low. Community studies have indicated that school-age children have the highest incidence of influenza and are an important source of amplifying and sustaining community transmission that affects all age groups. METHODS A consultation to discuss the advantages and disadvantages of a universal recommendation for annual influenza vaccination of all children age ≥6 months was held in Atlanta, Georgia, in September 2007. Consultants provided summaries of current data on vaccine effectiveness, safety, supply, successful program implementation, and economics studies and discussed challenges associated with continuing a risk- and contact-based vaccination strategy compared with a universal vaccination recommendation. RESULTS Consultants noted that school-age children had a substantial illness burden caused by influenza, that vaccine was safe and effective for children aged 6 months through 18 years, and that evidence suggested that vaccinating school-age children would provide benefits to both the vaccinated children and their unvaccinated household and community contacts. However, implementation of an annual recommendation for all school-age children would pose major challenges to parents, medical providers and health care systems. Alternative vaccination venues were needed, and of these school-located vaccination programs might offer the most promise as an alternative vaccination site for school-age children. CONCLUSIONS Expansion of recommendations to include all school-age children will require additional development of an infrastructure to support implementation and methods to adequately evaluate impact.

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Section: Immunization Program Issuesmentioning

confidence: 99%

Expanding the Recommendations for Annual Influenza Vaccination to School-Age Children in the United States

et al. 2012

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“…6,7,10 Because adolescents present infrequently for primary health care visits, 5,12 reminder/recall for adolescent immunizations is attractive in concept. 13,14 Nevertheless, little evidence exists for the effectiveness of practice-based reminder/recall for adolescent immunizations, 15,16 although in one recent study in 4 practices researchers demonstrated increased immunization rates. 17 Moreover, few practices actually use reminder/recall for patients of any age [18][19][20] ; barriers include the added workload, costs, and complexities of conducting such a program.…”

Section: Introductionmentioning

confidence: 99%

A Randomized Trial of the Effect of Centralized Reminder/Recall on Immunizations and Preventive Care Visits for Adolescents

Szilâgyi

Albertin

Humiston

et al. 2013

Academic Pediatrics

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104

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Objective-To assess the impact of a managed care-based patient reminder/recall system on immunization rates and preventive care visits among low-income adolescents.Methods-We conducted a randomized controlled trial between December 2009 and December 2010 that assigned adolescents aged 11-17 years to one of three groups: mailed letter, telephone reminders, or control. Publicly insured youths (n = 4, 115) were identified in 37 participating primary care practices. The main outcome measures were immunization rates for routine vaccines (meningococcus, pertussis, HPV) and preventive visit rates at study end.Results-Intervention and control groups were similar at baseline for demographics, immunization rates, and preventive visits. Among adolescents who were behind at the start, immunization rates at study end increased by 21% for mailed (P < .01 vs control), 17% for telephone (P < .05), and 13% for control groups. The proportion of adolescents with a preventive visit (within 12 months) was: mailed (65%; P <.01), telephone (63%; P <.05), and controls (59%). The number needed to treat for an additional fully vaccinated adolescent was 14 for mailed and 25 for telephone reminders; for an additional preventive visit, it was 17 and 29. The intervention cost $18.78 (mailed) or $16.68 (phone) per adolescent per year to deliver. The cost per additional adolescent fully vaccinated was $463.99 for mailed and $714.98 for telephone; the cost per additional adolescent receiving a preventive visit was $324.75 and $487.03.Conclusions-Managed care-based mail or telephone reminder/recall improved adolescent immunizations and preventive visits, with modest costs and modest impact.

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“…This increase will be a burden on primary care practices, given the time and resources needed to vaccinate the majority of adolescents. 3 Even though rates of influenza vaccinations are still low among adolescents, if they were to increase per current recommendations, the burden to primary health care providers could be significant. To address the need of patients to schedule travel to providers' offices, and the concerns of offices having to create resources to supply a potentially overwhelming demand, alternative immunization sites will be needed to deliver influenza vaccines to adolescents each year.…”

Section: Introductionmentioning

confidence: 99%

Focusing on flu

Short

Middleman

2013

Human Vaccines & Immunotherapeutics

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Additional Visit Burden for Universal Influenza Vaccination of US School-Aged Children and Adolescents

Cited by 47 publications

References 43 publications

Expanding the Recommendations for Annual Influenza Vaccination to School-Age Children in the United States

Expanding the Recommendations for Annual Influenza Vaccination to School-Age Children in the United States

A Randomized Trial of the Effect of Centralized Reminder/Recall on Immunizations and Preventive Care Visits for Adolescents

Focusing on flu

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