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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" dtd-version="1.3" xml:lang="en" article-type="research-article"><?properties manuscript?><processing-meta base-tagset="archiving" mathml-version="3.0" table-model="xhtml" tagset-family="jats"><restricted-by>pmc</restricted-by></processing-meta><front><journal-meta><journal-id journal-id-type="nlm-journal-id">9203213</journal-id><journal-id journal-id-type="pubmed-jr-id">1135</journal-id><journal-id journal-id-type="nlm-ta">Clin Infect Dis</journal-id><journal-id journal-id-type="iso-abbrev">Clin Infect Dis</journal-id><journal-title-group><journal-title>Clinical infectious diseases : an official publication of the Infectious Diseases Society of America</journal-title></journal-title-group><issn pub-type="ppub">1058-4838</issn><issn pub-type="epub">1537-6591</issn></journal-meta><article-meta><article-id pub-id-type="pmid">25501987</article-id><article-id pub-id-type="pmc">10132178</article-id><article-id pub-id-type="doi">10.1093/cid/ciu979</article-id><article-id pub-id-type="manuscript">HHSPA1893498</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Seasonal Influenza Vaccination Rates in the HIV Outpatient Study&#x02014;United States, 1999&#x02013;2013</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Durham</surname><given-names>Marcus D.</given-names></name><degrees>MS</degrees><xref rid="A1" ref-type="aff">1</xref></contrib><contrib contrib-type="author"><name><surname>Buchacz</surname><given-names>Kate</given-names></name><xref rid="A1" ref-type="aff">1</xref></contrib><contrib contrib-type="author"><name><surname>Armon</surname><given-names>Carl</given-names></name><xref rid="A2" ref-type="aff">2</xref></contrib><contrib contrib-type="author"><name><surname>Patel</surname><given-names>Pragna</given-names></name><xref rid="A1" ref-type="aff">1</xref></contrib><contrib contrib-type="author"><name><surname>Wood</surname><given-names>Kathy</given-names></name><xref rid="A2" ref-type="aff">2</xref></contrib><contrib contrib-type="author"><name><surname>Brooks</surname><given-names>John T.</given-names></name><xref rid="A1" ref-type="aff">1</xref></contrib><contrib contrib-type="author"><collab>HIV Outpatient Study (HOPS) Investigators</collab><xref rid="FN1" ref-type="author-notes">a</xref></contrib></contrib-group><aff id="A1"><label>1</label>Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia;</aff><aff id="A2"><label>2</label>Cerner Corporation, Vienna, Virginia</aff><author-notes><fn fn-type="other" id="FN1"><label>a</label><p id="P1">The HIV Outpatient Study Investigators are listed in the Acknowledgements.</p></fn><corresp id="CR1">Correspondence: Marcus D. Durham, MS, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS-E45, Atlanta, GA 30333 (<email>mvd8@cdc.gov</email>).</corresp></author-notes><pub-date pub-type="nihms-submitted"><day>19</day><month>4</month><year>2023</year></pub-date><pub-date pub-type="ppub"><day>15</day><month>3</month><year>2015</year></pub-date><pub-date pub-type="epub"><day>11</day><month>12</month><year>2014</year></pub-date><pub-date pub-type="pmc-release"><day>26</day><month>4</month><year>2023</year></pub-date><volume>60</volume><issue>6</issue><fpage>976</fpage><lpage>977</lpage><permissions><license><license-p>This work is written by (a) US Government employee(s) and is in the public domain in the US.</license-p></license></permissions></article-meta></front><body><p id="P2">To The Editor&#x02014;Due to the high burden of estimated annual deaths and hospitalizations associated with influenza epidemics in the United States [<xref rid="R1" ref-type="bibr">1</xref>, <xref rid="R2" ref-type="bibr">2</xref>], annual influenza vaccination is recommended for persons aged &#x02265;6 months, and for those who are at increased risk of influenza-related complications, including persons with human immunodeficiency virus (HIV) infections [<xref rid="R3" ref-type="bibr">3</xref>]. In 2011, we published data from the HIV Outpatient Study (HOPS), an open prospective HIV cohort study of HIV-infected outpatients seen in 9 well-established community-based private practices, public health clinics, and university-based clinics, describing annual rates of influenza vaccination among HIV-infected persons in care during influenza seasons from 1999 to 2008 [<xref rid="R4" ref-type="bibr">4</xref>]. We found that an average of 35% of HOPS participants received an influenza vaccination while under observation during the time period under investigation. This letter serves as an update to the previous analysis by including 5 years of additional data describing influenza vaccination rates among HOPS participants through 30 June 2013.</p><p id="P3">Among 6548 active patients (patients with at least 1 clinical encounter during the time period under investigation), 4788 were vaccinated at any time between 1 July 1999 and 30 June 2013. The annual vaccination rates ranged from a low of 26.4% to a high of 50.9% (average, 38.7%; linear regression trend <italic toggle="yes">P</italic> = .043; <xref rid="F1" ref-type="fig">Figure 1</xref>) during the influenza seasons studied. The HOPS recorded the highest rate of vaccination during the 2009&#x02013;2010 H1N1 influenza season, but that level was not sustained in subsequent seasons. Although we detected an overall temporal increase in influenza vaccination rates over the 14-year period, the observed rates continued to be consistently lower than published recommendations and below the goal of 70% set for Healthy People 2020 [<xref rid="R3" ref-type="bibr">3</xref>, <xref rid="R5" ref-type="bibr">5</xref>], underscoring the need for improving adherence to guidelines for annual influenza vaccination for HIV-infected persons.</p></body><back><ack id="S1"><title>Acknowledgments.</title><p id="P4">The HIV Outpatient Study Investigators include the following persons and sites: John T. Brooks, Kate Buchacz, Marcus D. Durham, Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; Harlen Hays, Kathleen C. Wood, Darlene Hankerson, Rachel Debes, Thilakavathy Subramanian, Carl Armon, Bonnie Dean, Dana Bryant Cerner Corporation, Vienna, Virginia; Frank J. Palella, Joan S. Chmiel, Saira Jahangir, Conor Daniel Flaherty, Jerian Denise Dixon-Evans, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Kenneth A. Lichtenstein, Cheryl Stewart, National Jewish Health, Denver, Colorado; John Hammer, Kenneth S. Greenberg, Barbara Widick, Rosa Franklin, Rose Medical Center, Denver, Colorado; Bienvenido G. Yangco, Kalliope Chagaris, Infectious Disease Research Institute, Tampa, Florida; Doug Ward, Troy Thomas, Patricia Avery, Dupont Circle Physicians Group, Washington, D.C.; Jack Fuhrer, Linda Ording-Bauer, Rita Kelly, Jane Esteves, State University of New York, Stony Brook; Ellen M. Tedaldi, Ramona A. Christian, Faye Ruley, Dania Beadle, Princess Graham, Temple University School of Medicine, Philadelphia, Pennsylvania; Richard M. Novak, Andrea Wendrow, Renata Smith, University of Illinois at Chicago; Benjamin Young, Barbara Widick, Mia Scott, APEX Family Medicine, Denver, Colorado.</p><sec id="S2"><title>Financial support.</title><p id="P5">This work was supported by the CDC (contract numbers 200-2001-00133, 200-2006-18797 and 200-2011-41872).</p></sec></ack><fn-group><fn id="FN2"><p id="P6"><bold><italic toggle="yes">Disclaimer</italic></bold>. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the CDC.</p></fn><fn fn-type="COI-statement" id="FN3"><p id="P7"><bold><italic toggle="yes">Potential conflicts of interest</italic>.</bold> All authors: No reported conflicts.</p><p id="P8">All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. 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