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Universal influenza vaccination among children, adolescents may increase burden of physician visits, data reveal

Wednesday, November 19 2008 | Comments

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What's This? Annual vaccination of all children and adolescents aged 5 to 18 years through their primary care physician's office would require additional office visits even if all visits are used as vaccination opportunities, new evidence demonstrates.

Researchers reviewed Medical Expenditure Panel Survey Household Component data from 2003 to 2004 to evaluate well-child care and other visits to a "medical home" (i.e., pediatric, family medicine and internal medicine primary care offices) as potential opportunities for receipt of influenza vaccine during the immunization season. The study sample included 454 children aged 5 to 6 years, 473 children aged 7 to 8 years and 2,120 adolescents aged 9 to 18 years, which represented a weighted population of 49.3 million children. Children aged younger than 9 years were assumed to need two vaccinations at least four weeks apart the first time they received a flu vaccination.

During a three-month window from October to December for vaccinations and using only well-child office visits for influenza vaccination opportunities, 97 percent of the youngest group and 98 percent of the middle age group would need one or two additional office visits to complete their vaccination. Ninety-five percent of the adolescent group would need one additional visit.

However, if all types of office visits were used as an opportunity to vaccinate during the three-month window, 90 percent of the youngest group and 91 percent of the middle age group would need one or two additional visits, whereas 78 percent of the adolescent group would need one additional visit.

Although using all types of office visits improved the influenza vaccination rates and lessened the additional visit burden, expanding the vaccination window to four months (from October to January) or five months (from October to February) only slightly reduced the additional office visit burden. Still, the researchers noted that lengthening the window of opportunity is important to notify families and enable vaccination of the large number of eligible children.

"[P]rimary care providers should offer the vaccine over the widest possible interval, vaccinate at every possible opportunity, implement intensive reminder/recall systems to notify eligible patients, perform audits to measure vaccination rates and mobilize offices to implement effective strategies to efficiently handle the increased visit volume," the investigators wrote.

The study was published in the November issue of the Archives of Pediatric & Adolescent Medicine.

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