Influenza vaccine for high-risk non-elderly adults: A national survey of subspecialists

Abstract

Despite long-standing recommendations for non-elderly adults with certain chronic pulmonary, cardiovascular and metabolic conditions to receive influenza vaccine, vaccination rates remain low. Visits to subspecialists represent an important vaccination opportunity, but little is known regarding subspecialists' perceptions related to influenza vaccination. In February 2003, we conducted a cross-sectional mail survey of a random sample (N = 2,007) of board-certified cardiologists, endocrinologists and pulmonologists from the entire United States who provided outpatient care to adults aged 18-64 years, to assess their patterns of and attitudes toward administering influenza vaccine to high-risk, non-elderly patients. The overall response rate was 33%. Among 621 eligible respondents, 483 stocked influenza vaccine in their practice (Stockers) and 138 did not stock the vaccine (Non-Stockers). Pulmonologists were most likely to stock vaccine and strongly recommend vaccination; cardiologists were least likely. Among Stockers, barriers to vaccination varied by subspecialty. Among Non-Stockers, the most common factor in the decision to not stock vaccine was the perception that patients will receive the vaccine elsewhere. Most subspecialists who provide care to a large proportion of high-risk, non-elderly persons recommend influenza vaccination to some degree, particularly pulmonologists. To reduce missed opportunities overall, subspecialists should be encouraged to vaccinate patients who say that they plan to get the vaccine elsewhere. For cardiologists in particular, barriers to stocking influenza vaccine and recommending vaccination more strongly must be addressed.

Uptake of Influenza Vaccination and Missed Opportunities Among Adults with High-Risk Conditions, United States, 2013

“…In addition, it is also important for subspecialists to recommend and offer influenza vaccination to high-risk adults. Although primary care physicians are the predominant providers for adults with chronic conditions in the health care system, subspecialists also see these patients with great frequency (35). However, one study indicated that about 22% of subspecialists did not stock the influenza vaccine.…”

“…However, one study indicated that about 22% of subspecialists did not stock the influenza vaccine. The most common factor in the decision to not stock vaccine was the perception that patients will receive the vaccine elsewhere (35). Subspecialists were less likely to stock and recommend influenza vaccine, especially cardiologists (35, 36).…”

“…The most common factor in the decision to not stock vaccine was the perception that patients will receive the vaccine elsewhere (35). Subspecialists were less likely to stock and recommend influenza vaccine, especially cardiologists (35, 36). To reduce missed opportunities overall, subspecialists should be encouraged to vaccinate high-risk patients or refer their patients for vaccination (35, 35).…”

Predictors of influenza vaccination uptake among adults with a history of heart attack

“…26 Research is called for into the role of cardiologists in recommending vaccination in Spain. Meanwhile, however, the interventions proposed by Davis et al such as improving communication between primary and cardiology practices, use of common healthinformation systems, and providing education initiatives for cardiologists which envisage influenza vaccination as part of chronic disease management, should be considered in our country.…”

“…Meanwhile, however, the interventions proposed by Davis et al such as improving communication between primary and cardiology practices, use of common healthinformation systems, and providing education initiatives for cardiologists which envisage influenza vaccination as part of chronic disease management, should be considered in our country. 26 Apart from strategies to improve implementation of vaccination by providers, available and effective interventions must be used to increase the awareness of and demand for vaccination by persons with a history of heart attack. [21][22][23][24] There are a number of study limitations.…”