220864 Successful pediatric influenza immunization program in an integrated community health center system

Wednesday, November 10, 2010 : 12:30 PM - 12:45 PM

Mary E. O'Connor, MD, MPH , Community Health Services, Pediatrics, Denver Health, University of Colorado School of Medicine, Denver, CO
Rachel Everhart, MS , Community Health Services, Denver Health, Denver, CO
Steven Federico, MD , Community Health Services, Pediatrics, Denver Health, University of Colorado School of Medicine, Denver, CO
Simon Hambidge, MD, PhD , Community Health Services, Pediatrics, Denver Health, University of Colorado School of Medicine, Denver
Recent recommendations to vaccinate all children against influenza have highlighted shortcomings in the vaccine delivery system. Improved delivery systems should improve influenza immunization rates and minimize disease. Integrated healthcare settings may meet this demand better. Denver Health (DH) is a community heath center system vertically integrated with a safety-net hospital and a centralized immunization registry.

We conducted a retrospective analysis of DH pediatric influenza vaccine coverage during 2008-2009. All DH active patients 6 months to 18 years of age were included. Age categories were used to stratify children consistent with recent CDC's age categorizations. We calculated odds ratios for DH full influenza immunization compared to those of recently published CDC sentinel sites. We assessed associations between DH characteristics of children and full influenza immunization.

36,541 DH children and adolescents received 17,370 influenza immunizations. Rates of full immunization for DH/CDC sentinel sites were: 6-23 months 43%/29%, 2-4 years 32%/22%, 5-10 years 25%/12%, 11-12 years 46%/13% and 13-18 years 32%/9%, all significantly different with odds ratio ranging from 1.84 (95%CI 1.76-1.94) to 6.46 (95%CI 5.98-6.97). Higher rates of full influenza immunization were seen in Spanish speaking families, in children seen in pediatric vs family medicine clinics or school based clinics except for 11-12 year old children who had higher immunization rates in school based clinics. Fully immunized children had more clinic visits in the prior 18 months than non immunized children (p<0.0001).

A vertically integrated community health system with a centralized immunization registry can successfully deliver influenza immunization to children and adolescents.

Learning Areas:
Conduct evaluation related to programs, research, and other areas of practice
Protection of the public in relation to communicable diseases including prevention or control
Provision of health care to the public

Learning Objectives:
1. Evaluate influenza vaccine delivery to children and adolescents in a community health center system utilizing family medicine, pediatric, and school based clinics 2. Compare the influenza immunization rates to CDC sentinel site data.

Keywords: Immunizations, Child/Adolescent

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a general pediatrician with research and public health background and an Associate Professor of Pediatrics at the University of Colorado School of Medicine
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.