Background: The current practice in an Outpatient Pediatric Center is to provide Influenza vaccine for any eligible child who presents during the Influenza season. No parent reminder system is implemented. We hypothesized that this practice has the potential for missing a significant number of children who do not have a scheduled annual well-child visit during the Influenza season.
Methods: This two-year cross-sectional study evaluated 1,059 children presenting for their annual three-year-old well-child visits from April 1st, 2014 to March 31st, 2016. We compared Influenza vaccination rates for children with visits April 1st to September 30th [outside] and October 1st to March 31st [during] the Influenza seasons. The latter date interval was chosen based on the availability of Influenza vaccine at this clinic for the season. A cohort including children who presented from April 1st to September 30th, 2015 was selected to evaluate implementation of parent reminder system. Each parent received a card with educational material on Influenza and was asked to write the home address on the card upon check-out. Completed cards were collected and later mailed as soon as Influenza vaccine was available. We studied Influenza vaccination rates before [2014-2015] and after [2015-2016] the intervention. Pearson Chi-Square test was used for statistical analysis.
Results: Over the two-year period, 576/1059 (54.4%) children had their annual visit outside the Influenza seasons. 125/576 (21.7%) came back and received the vaccine. 216/483 (44.7%) children with visits during the Influenza seasons received their vaccine. The association between annual visit date and Influenza vaccination status was statistically significant [P-value<0.01]. Annual Influenza vaccination rates were 33% and 31% for three-year-old children before and after implementing parent reminder cards respectively [P-value=0.61]. 70/288 parents submitted their cards.
Conclusion: Three-year-old children were twice less likely to receive Influenza vaccine if their annual visit was outside the Influenza season. Reminder cards did not improve annual Influenza vaccination rates for three-year-old children at the clinic. Limiting factors included parental refusal to fill the cards, parental views on Influenza vaccine, and distribution of cards at check-out.
Hiba Chehab, MD, Pediatrics, Ryan White Center for Pediatric Infectious Disease/Indiana University School of Medicine, Indianapolis, IN and Michael Mckenna, MD, Pediatrics, Indiana University, Indianapolis, IN