Practice and Child Characteristics Associated With Influenza Vaccine Uptake in Young Children

Abstract

Objective-To determine both practice and child characteristics and practice strategies associated with receipt of influenza vaccine in young children during the 2004-2005 influenza season, the first season for the universal influenza vaccination recommendation for all children aged 6-23 months.Methods-Clinical and demographic data from randomly selected children aged 6-23 months were obtained by chart review from a community-based cohort study in three U.S. counties. The proportion of children vaccinated by April 5, 2005 in each practice was obtained. To assess practice characteristics and strategies, sampled practices received a self-administered practice survey. Practice and child characteristics predicting complete influenza vaccination were determined using multinomial logistic regression.Results-Forty-six (88%) of 52 sampled practices completed the survey and permitted chart reviews. Of 2384 children aged 6-23 months who were studied, 27% were completely vaccinated. The proportion of children completely vaccinated varied widely among practices (0-71%). Most practices (87%) implemented ≥ 1 vaccination strategy (year-round discussion with parents about influenza vaccine, evening/weekend influenza vaccine clinics, standing orders, or saving a second dose for children who had received the first of two recommended doses). Complete influenza vaccination was associated with three practice characteristics--suburban location, lower patient volume, and vaccination strategies of evening/weekend vaccine clinics; and with child characteristics of younger age, existing high-risk conditions, ≥ 6 well visits to the practice by age 3 years, and any practice visit from October through January. [2004][2005]7 to children aged 6-59 months in [2006][2007]8 and to children aged 6 months-18 years in 2009-2010. 9 The administration of influenza vaccine presents unique challenges to healthcare providers since it requires yearly administration during a relatively short time period. Vaccine supply delays and shortages can occur, making it difficult for practices to predict when vaccination campaigns might begin and whether adequate supplies will be available. Because of poor immunogenicity of a single dose of vaccine in young children, two doses are required for children aged <9 years who previously have not been completely vaccinated. 9 Most studies evaluating methods to increase vaccination rates in young children were reported prior to the universal influenza vaccination recommendations for young children. [10][11][12][13][14] Since the majority of childhood vaccines are administered in primary care settings, 15 we sought to determine both practice and child characteristics and practice strategies that were associated with influenza vaccine coverage among children aged 6-23 months in 2004-2005, the first season that influenza vaccine was universally recommended. Methods Institutional Review BoardThis study was approved by the institutional review board of the Centers for Disease Control and Prevention (CDC) and of each ...