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

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.