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APHA Scientific Session and Event Listing

Marlene M. Lugg, Dr PH, Kaiser Permenents, 13652 Cantara Street, Panorama City, CA 91402, 818-375-3078, marlene.m.lugg@kp.org

Southern California Kaiser Permanente serves 3 million members in 11 medical centers and 60 medical office buildings. A centralized immunization tracking system (KITS) is accessible from all departments, and currently contains over 26 million immunization entries.

Previous studies reported on methods used in 2003-4 to increase pneumococcal immunization rates for older and high-risk patients from under 65% to 90%. Rates did not improve further, so an attempt was made to discover why.

A list of members aged 65 and older who did not have evidence of pneumococcal immunization in KITS as of July 1, 2005 was developed, and all hard-copy clinical charts were obtained. The author audited all charts personally, with the following results. Twelve percent of the charts contained evidence of a previous pneumococcal immunization, which had been given before KITS was established. These were back entered into KITS. Seventy-four percent had no notation in the charts regarding pneumococcal vaccinations, and these are being followed up with telephone calls and/or letters, as described in previous studies. The most surprising result, however, was that 14% of patients who should have been immunized with pneumococcal vaccines, refused this immunization. Many of them refused several times, year after year, in spite of being encouraged to have this immunization by their physician.

The result of this study indicates that new or different methods of reaching these patients need to be developed in order to decrease the number of persons unprotected against invasive pneumococcal infection.

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Learning Objectives: