Improving influenza immunization rates for high risk patients

BACKGROUND: Southern California Kaiser Permanente serves 3 million members in 11 medical centers and 60 medical buildings. Influenza immunization rates have historically been less than desired.

OBJECTIVES: To improve influenza immunization rates in high-risk groups

METHODS:

In 2004, 16% of Kaiser patients received a flu shot. Beginning in 2005, with increased age and risk factor indicators, letters were sent to children 6 - 59 months old, persons over 50, or with asthma, coronary artery disease, COPD, chronic kidney disease, diabetes, cystic fibrosis, etc. Special efforts were made to immunize pregnant women. Overall rates went to 22% in 2005 (66% over 65's), and will be slightly higher for the 2006-7 season. (Risk groups' rates will be presented.)

Compliance varies, with the highest rate in the medical center with the highest education/income level patients. Higher rates were also found in centers where getting the injection was easier (“drive-through clinic”) and check-in and waiting time were shorter.

Patients/parents not receiving flu shots were interviewed and stated: “I've never given the shot to my children before, and they didn't get sick,” or “No, because it gives me the flu.”

CONCLUSIONS:

Influenza immunization rates vary greatly depending on the perceived and actual availability of vaccine, severity of the previous “flu season”, educational level of the patient, and ease of receiving the immunization. Better methods of health education and ease of receiving the vaccine must be found to convince patients to have their “flu shots”.