Increasing Childhood Influenza Vaccination

Details

• Alternative Title:
  Am J Prev Med
• Personal Author:
  Nowalk, Mary Patricia ; Lin, Chyongchiou J. ; Hannibal, Kristin ; Reis, Evelyn C. ; Gallik, Gregory ; Moehling, Krissy K. ; Huang, Hsin-Hui ; Allred, Norma J. ; Wolfson, David H. ; Zimmerman, Richard K.
• Description:
  Background
  
  Since the 2008 inception of universal childhood influenza vaccination, national rates have risen more dramatically among younger children than older children and reported rates across racial/ethnic groups are inconsistent. Interventions may be needed to address age and racial disparities to achieve the recommended childhood influenza vaccination target of 70%.
  
  Purpose
  
  To evaluate an intervention to increase childhood influenza vaccination across age and racial groups.
  
  Methods
  
  In 2011–2012, 20 primary care practices treating children were randomly assigned to Intervention and Control arms of a cluster randomized controlled trial to increase childhood influenza vaccination uptake using a toolkit and other strategies including early delivery of donated vaccine, in-service staff meetings, and publicity.
  
  Results
  
  The average vaccination differences from pre-intervention to the intervention year were significantly larger in the Intervention arm (n=10 practices) than the Control arm (n=10 practices), for children aged 2–8 years (10.2 percentage points (pct pts) Intervention vs 3.6 pct pts Control) and 9–18 years (11.1 pct pts Intervention vs 4.3 pct pts Control, p<0.05), for non-white children (16.7 pct pts Intervention vs 4.6 pct pts Control, p<0.001), and overall (9.9 pct pts Intervention vs 4.2 pct pts Control, p<0.01). In multi-level modeling that accounted for person- and practice-level variables and the interactions among age, race and intervention, the likelihood of vaccination increased with younger age group (6–23 months), white race, commercial insurance, the practice’s pre-intervention vaccination rate, and being in the Intervention arm. Estimates of the interaction terms indicated that the intervention increased the likelihood of vaccination for non-white children in all age groups and white children aged 9–18 years.
  
  Conclusions
  
  A multi-strategy intervention that includes a practice improvement toolkit can significantly improve influenza vaccination uptake across age and racial groups without targeting specific groups, especially in practices with large percentages of minority children.
  
  
• Keywords:
  Adolescent Age Factors Child Child, Preschool Female Humans Immunization Programs Infant Influenza, Human Influenza Vaccines Male Primary Health Care Racial Groups Vaccination White People

  More +
• Source:
  Am J Prev Med. 47(4):435-443
• Pubmed ID:
  25113138
• Pubmed Central ID:
  PMC4208625
• Document Type:
  Journal Article
• Funding:
  U01 IP000321/IP/NCIRD CDC HHSUnited States/ ; UL1 RR024153/RR/NCRR NIH HHSUnited States/ ; UL1 TR000005/TR/NCATS NIH HHSUnited States/ ; UL1TR000005/TR/NCATS NIH HHSUnited States/
• Volume:
  47
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:e8d89b6df5f419dc30360593be9b07859db263d73bde5cfffe0bdf0b96691b40
• Download URL:
  https://stacks.cdc.gov/view/cdc/36657/cdc_36657_DS1.pdf
• File Type:
  [PDF - 419.31 KB ]