Effects of multicomponent primary care-based intervention on immunization rates and missed opportunities to vaccinate adults

Abstract

Background: Adult immunization rates are below Healthy People 2020 targets. Our objective was to evaluate the effectiveness of a multicomponent intervention to improve adult immunization rates. Methods: This prospective interventional before-and-after non-randomized study was conducted through the American Academy of Family Physicians National Research Network with 43 primary care physicians from a large multi-specialty healthcare organization (multicomponent intervention group n = 23; comparator group n = 20) in the United States. The multicomponent intervention included provider reminders, quarterly provider-level performance reports, provider education, patient visual aid materials, and standing orders on adult pneumococcal, influenza, and zoster immunizations. We assessed individual and comparative provider-level vaccination rates and missed opportunities detailing concordance with targets established by Healthy People 2020 for pneumococcal, influenza, and zoster immunizations. Results: Vaccination rates increased after 12 months in intervention and comparator groups respectively for: a). influenza from 44.4 ± 16.7 to 51.3% ± 12.9% (by 6.9 percentage points, p = 0.001) and from 35.1 ± 19.1 to 41.3% ± 14.2%, (by 6.2 percentage points, p = 0.01); b). pneumococcal vaccinations in older adults from 62.8 ± 17.6 to 81.4% ± 16.6% (by 18.6 percentage points, for p < 0.0001) and from 55.9 ± 20.0 to 72.7% ± 18.4% (by 16.7 percentage points, p < 0.0001); and c). zoster from 37.1 ± 13.4 to 41.9% ± 13.1% (by 4.8 percentage points, p < 0.0001) and from 35.0 ± 18.7 to 42.3% ± 20.9% (7.3 percentage points, p = 0.001).

Change of Willingness to Accept COVID-19 Vaccine and Reasons of Vaccine Hesitancy of Working People at Different Waves of Local Epidemic in Hong Kong, China: Repeated Cross-Sectional Surveys

“…Considering all this, information dissemination efforts on safety of the vaccination, which are as important as efficacy and effectiveness of the vaccine, should be enhanced by health authorities and organizations, particularly through online social media where the issue of misinformation is severe [35,36,40]. The primary care sector should also be engaged in health education to increase vaccination coverage [41]. For the information dissemination, there should not only be information about the safety of the vaccination but also messages conveying that vaccination is a part of the individual infection control precautions that would complement social distancing and handwashing in disease prevention, and could be helpful to both individuals and communities to resume normal life.…”

Effectiveness of educational interventions for healthcare workers on vaccination dialogue with older adults: a systematic review

“…or required active assistance from administrators/nurses to remind practicing physicians to vaccinate. The most targeted immunization was influenza vaccination ( n = 33) [ 20 – 32 , 36 , 38 , 39 , 41 – 46 , 48 – 51 , 54 , 57 , 59 , 60 , 63 , 64 , 67 , 69 , 70 ], pneumococcal ( n = 27) [ 22 , 23 , 25 , 28 , 30 , 31 , 34 , 37 , 39 , 40 , 42 , 45 , 46 , 51 – 56 , 58 , 59 , 61 – 65 , 67 ] and tetanus ( n = 8) [ 23 , 25 , 28 , 33 , 35 , 36 , 39 , 47 , 68 ], while herpes zoster was least targeted ( n = 2) [ 62 , 64 ]. Most interventions were tested in outpatient care, including primary care and family medicine ( n = 26), while eleven studies were hospital-based.…”

“…A total of seventeen studies investigated the behavioural changes among HCWs consequent to specific interventions [ 24 , 25 , 28 , 30 , 31 , 33 , 34 , 37 – 40 , 45 , 47 , 58 , 59 , 64 , 66 ]. A common outcome utilized was the proportion of offered or ordered vaccines.…”

Increasing pneumococcal vaccine uptake in older adults: a scoping review of interventions in high-income countries

“…Eleven studies evaluated interventions based within primary care [24,25,27,31,37,38,42,43,60,61,63]. Eight studies noted significant improvement in vaccination rates.…”