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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
3334.0: Monday, December 12, 2005 - Board 9

Abstract #117829

Can influenza vaccine availability in emergency departments overcome the barrier of a patient’s lack of a primary care physician?

Aubrey F. Lipham, BS, Salman Baghian, BS, Dale M. Marioneaux, BS, MEd, Monica Pradhan, BS, MNS, and William M. Cassidy, MD. Department of Medicine, Louisiana State University Health Sciences Center, 5825 Airline Hwy., Baton Rouge, LA 70805, 225-354-2001, alipha@lsuhsc.edu

Background: Lacking a primary care physician (PCP) is associated with decreased likelihood of influenza vaccination. Vaccinating in emergency departments (ED) could overcome this barrier. Methods: Indications for vaccination were assessed in two EDs in December 2004 and January 2005. Patients were asked if they had a PCP. In December, patients reported how many flu vaccinations they received in the previous 5 years. Indications for vaccine, immunization acceptance, and administration were recorded. Although Medicare patients were targeted in December, all persons were offered the vaccination if they had indications. Results: 838/1201 (69.8%) had indications for influenza vaccination. 682/838 (81.4%) had PCPs and 131 (15.6%) did not. 217 (31.8%) of those with a PCP were up-to-date (UTD) prior to visit in the ED & 16 (12.2%) of those without a PCP were UTD (p<0.001). Of those not UTD, 40% persons with a PCP and 45.2% persons without a PCP were vaccinated in the ED. Reasons why the remaining 63 without a PCP and not UTD were not vaccinated were MD refusal (15.9%), contraindications (12.7%), patient discharged (4.8%), patient refusal (58.7%) and unknown reasons (4.7%). 6/17 (35%) vaccinated in December had not received a flu shot in the last 5 years. Conclusions: Lacking a PCP is a risk factor for not receiving influenza vaccination. Similar percentages of vaccination for the groups with PCPs and those without show that the ED program was successful in overcoming this barrier. The 55% without PCP's who were not vaccinated in the ED suggests that other obstacles exist.

Learning Objectives:

Keywords: Immunizations, Emergency Department/Room

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

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The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA