Abstract
Mobile Flu Fighter!: Development and implementation of a mobile vaccination initiative to reduce pediatric influenza vaccination disparities in Nashville, Tennessee
APHA 2022 Annual Meeting and Expo
Background:
Pediatric influenza morbidity and mortality disproportionately affect racial and ethnic minority groups [hospitalization age-adjusted rate ratio = 1.8 for non-Hispanic Black (Black) compared to non-Hispanic White (White)], yet pediatric influenza vaccination rates are often lower in these populations (2020-21 influenza vaccination coverage 49.1% for Black compared to 60.4% for White). Efforts to provide education on influenza vaccines and community-based access to influenza immunizations could allow for greater vaccination rates among these groups.
Objective:
To develop and pilot an initiative, Mobile Flu Fighter!, to provide influenza vaccine education and on-site vaccines for pediatric populations.
Methods:
The Vanderbilt Pediatric Primary Care clinic (VPPC) identified zip codes correlating with Black pediatric patients (age 6 months to ≤ 21 years) with the lowest influenza vaccine rates for the 2020-21 season (~38%). Five Mobile Flu Fighter! events were planned for the 2021-22 influenza season in Nashville, TN by these zip codes. Free vaccines, prizes, snacks, and food were provided at events through coordination with community partners. Text messages were sent to all VPPC patients living in zip codes corresponding to event locations. Vaccines were provided to eligible children. Written caregiver consent was obtained prior to vaccine administration. Vaccinations were recorded in Vanderbilt EMR and the state registry. VPPC influenza vaccination rates were assessed through March 31, 2022 and compared to the previous season overall, by zip code and by reported race.
Results:
Four out of five planned Mobile Flu Fighter! events were conducted by the end of 2021, resulting in a cumulative total of 49 pediatric influenza vaccinations. The final event was canceled due to COVID-19. Vaccinated patients were representative of multiple races/ethnicities, including 69.4% Black, 8% White, 4% Hispanic White, 2% Biracial, and 16.3% Race Unknown. 6342 text reminders were sent and reached a total of 2114 caregivers of pediatric patients (event 1: 512, event 2: 549, event 3: 522, and event 4: 531). Influenza vaccine uptake decreased by 5.8% among Black children between the 2020-2021 and 2021-2022 influenza seasons. Between-season vaccine rates among Black children within the 37013 and 37207 zip codes decreased by 6.5% and 4.2%, respectively.
Conclusions/Implications:
Despite a decrease in seasonal flu vaccinations, a mobile influenza vaccine initiative targeting minority groups was successfully implemented. The ongoing COVID-19 pandemic and increasing vaccine hesitancy likely affected our results. Future mobile clinics could include offering influenza vaccinations for all age groups to create a family approach to receiving routine medical care.