Background: Adult vaccination provides health-related and economic benefits, yet vaccination rates remain below national targets. We describe baseline vaccination rates for influenza, herpes zoster (HZ), tetanus diphtheria acellular pertussis (Tdap), and 13-valent pneumococcal conjugate (PCV13) and vaccination rates after implementation of a multi-modal intervention to improve vaccination in primary care clinics of a large integrated health system.
Methods: We estimated vaccination rates during the pre-intervention baseline period (May 2014April 2016), and during the early intervention period (May 2016December 2016). Interventions including health-care provider vaccine education, clinic vaccine champions, electronic health record (EHR) integration with the statewide immunization registry, student pharmacist placement for patient education, EHR provider alerts for vaccination, messaging to patients via an EHR patient portal and an electronic insurance claims processing system were deployed across 15 ambulatory primary care clinics serving patients ≥18 years in Southeast Michigan.
Results: During the baseline period, 77,833 (46.4%; 2014-15) and 82,694 (50.5%; 2015-16) eligible patients received influenza vaccine; 36,569 (56.8%) eligible patients received influenza vaccine during the intervention period covering 3 peak months (OctoberDecember) of the 2016-17 influenza season (Figure 1). During baseline and intervention periods, 45,392 (38.8%) and 21,928 (43%) eligible patients were vaccinated for HZ, respectively. For Tdap vaccine, 163,377 (56.8%) and 70,842 (65.4%) of patients were vaccinated during the baseline and intervention periods (Figure 2). PCV13 vaccination increased in patients aged ≥65 years of age from 25.7% during the baseline period to 68.4% during the intervention period (Figure 3).
Conclusion: Through the baseline and into the early intervention period, vaccination rates for influenza, HZ, Tdap and PCV13 vaccines increased. Analysis is ongoing to evaluate the contribution of study interventions to increased vaccination over baseline rates. Results of this program may benefit other healthcare systems to reduce observed disparities in vaccination among adult patient populations.
T. Prentiss, Merck, Inc.: Investigator , Research grant
L. Kaljee, Merck, Inc.: Investigator , Research grant
L. Lamerato, Merck, Inc.: Investigator , Research grant
S. Zhang, Merck, Inc.: Investigator , Research grant
G. Divine, Merck, Inc.: Investigator , Research grant
H. Misikir, Merck, Inc.: Investigator , Research grant
M. J. Zervos, Merck, Inc.: Investigator , Research grant