Improving Immunization Rates at 18 Months of Age: Implications for Individual Practices

McElligott, James T.; Roberts, James R.; O’Brien, Elizabeth; Freeland, Katherine D.; Kolasa, Maureen; Stevenson, John; Darden, Paul M.

doi:10.1177/00333549111260s205

Cited by 6 publications

(3 citation statements)

References 12 publications

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“…Although previous studies [1,16] have suggested that LAIV has greater VE than IIV in young children, several recent studies have not supported those findings. LAIV had low VE in 2013-2014 [3,17,18], possibly due to the heat instability of the A/H1N1 [19,20] construct, which was changed for the 2015-2016 vaccine.…”

Section: Discussionmentioning

confidence: 89%

2014–2015 Influenza Vaccine Effectiveness in the United States by Vaccine Type

et al. 2016

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Background. Circulating A/H3N2 influenza viruses drifted significantly after strain selection for the 2014-2015 vaccines. Also in 2014-2015, the Advisory Committee on Immunization Practices recommended preferential use of live attenuated influenza vaccine (LAIV) over inactivated influenza vaccine (IIV) among children aged 2-8 years.Methods. Vaccine effectiveness (VE) across age groups and vaccine types was examined among outpatients with acute respiratory illness at 5 US sites using a test-negative design, that compared the odds of vaccination among reverse transcription polymerase chain reaction-confirmed influenza positives and negatives.Results. Of 9311 enrollees with complete data, 7078 (76%) were influenza negative, 1840 (19.8%) were positive for influenza A (A/H3N2, n = 1817), and 395 (4.2%) were positive for influenza B (B/Yamagata, n = 340). The overall adjusted VE was 19% (95% confidence interval [CI], 10% to 27%) and was statistically significant in all age strata except those aged 18-64 years. The adjusted VE of 6% (95%CI, −5% to 17%) against A/H3N2-associated illness was not statistically significant, unlike VE for influenza B/Yamagata, which was 55% (95%CI, 43% to 65%). Among those aged 2-8 years, VE against A/H3N2 was 15% (95%CI, −16% to 38%) for IIV and −3% (CI, −50% to 29%) for LAIV; VE against B/Yamagata was 40% (95%CI, −20% to 70%) for IIV and 74% (95%CI, 25% to 91%) for LAIV.Conclusions. The 2014-2015 influenza vaccines offered little protection against the predominant influenza A/H3N2 virus but were effective against influenza B. Preferential use of LAIV among young children was not supported.

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Section: Discussionmentioning

confidence: 89%

2014–2015 Influenza Vaccine Effectiveness in the United States by Vaccine Type

et al. 2016

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“…Moreover, the variation might be due to the difference in the status of the study settings where half of the study facilities in this study are referral facilities having high client flows and creating a high workload which may reduce child screening for vaccination status. Evidence had confirmed that screening children for vaccination during any contact with health services improves immunization coverage by reducing missed opportunities for vaccinations [ 40 ]. However, the screening practice was low (58.53%) in this study.…”

Section: Discussionmentioning

confidence: 99%

Missed opportunity for routine vaccination and associated factors among children aged 0–23 months in public health facilities of Jimma Town

Abatemam,

Wordofa,

Worku

2023

PLOS Glob Public Health

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The current recommendation obligates children to receive all vaccines within two years of birth. The Expanded Program on Immunization (EPI) was established in Ethiopia to increase the immunization rate by 10% annually and to reach 100% in 10 years but not been achieved in twenty years. Missed opportunity for vaccination (MOV) is one of the major factors in vaccination coverage. Hence, this study aimed to assess the prevalence of MOV and associated factors in Jimma Town public health facilities. A facility-based cross-sectional study design was employed with a quantitative data collection method. The sample size was calculated using a single population proportion formula. The data were collected through face-to-face interviews, and data extraction methods and analyzed using SPSS version 26. The statistical association was decided at p-value <0.05 with 95% CI, and AOR. A total of 422 children were involved in this study making a 100% response rate. The magnitude of MOV was 39.8% (95%CI: 35–45). Parents/caretakers have not attended formal education (AOR = 4.65, CI:1.64–13.24), residing in rural (AOR = 2.60, CI: 1.35–5.03), poor knowledge about immunization (AOR = 2.61, CI: 1.58–4.30), the child not assessed for vaccination status (AOR = 3.01, CI: 1.65–5.49), and parents/caretakers not seen/heard vaccination message in the last month (AOR = 2.42, CI: 1.40–4.18) were statistically positively associated with the MOV. In conclusion, this study indicated that MOV among the children was high in the study facilities. The researchers recommended stakeholders work on strengthening community awareness creation. Additionally, further study incorporating physician-related factors is also suggested.

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“…[5][6][7] Increasing immunization rates therefore remains a perennial target for quality improvement (QI) in pediatrics. [8][9][10][11][12] Our practice began immunization improvement work in 1996 with the development of a home-grown immunization database. This database preceded the Massachusetts Immunization Information System (MIIS), launched in 2011 by the state Department of Public Health.…”

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confidence: 99%

Improving Immunization Rates in a Hospital-Based Primary Care Practice

et al. 2014

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We implemented a quality improvement initiative aimed at reaching a 95% immunization rate for patients aged 24 months. The setting was a hospital-based pediatric primary care practice in Boston, Massachusetts. We defined immunization as full receipt of the vaccine series as recommended by the Centers for Disease Control and Prevention. METHODS:The initiative was team-based and structured around 3 core interventions: systematic identification and capture of target patients, use of a patient-tracking registry, and patient outreach and care coordination. We measured monthly overall and modified immunization rates for patients aged 24 months. The modified rate excluded vaccine refusals and practice transfers. We plotted monthly overall and modified immunization rates on statistical process control charts to monitor progress and evaluate impact. RESULTS:We measured immunization rates for 3298 patients aged 24 months between January 2009 and December 2012. Patients were 48% (n = 1576) female, 77.3% (n = 2548) were African American or Hispanic, and 70.2% (n = 2015) were publicly insured. Using control charts, we established mean overall and modified immunization rates of 90% and 93%, respectively. After implementation, we observed an increase in the mean modified immunization rate to 95%.CONCLUSIONS: A quality improvement initiative enabled our pediatric practice to increase its modified immunization rate to 95% for children aged 24 months. We attribute the improvement to the incorporation of medical home elements including a multidisciplinary team, patient registry, and care coordination.

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Improving Immunization Rates at 18 Months of Age: Implications for Individual Practices

Abstract: Practice-based interventions aimed at encouraging an 18-month well-child visit that emphasizes delivery of vaccines have the potential to substantially increase timely vaccination rates among individual practices.

Cited by 6 publications

References 12 publications

2014–2015 Influenza Vaccine Effectiveness in the United States by Vaccine Type

2014–2015 Influenza Vaccine Effectiveness in the United States by Vaccine Type

Missed opportunity for routine vaccination and associated factors among children aged 0–23 months in public health facilities of Jimma Town

Improving Immunization Rates in a Hospital-Based Primary Care Practice

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