Four Year Experience with Mandatory Seasonal Influenza Immunization for All Personnel in a University Medical Center

ABSTRACT Introduction Influenza is a globally occurring viral respiratory infection that can lead to hospitalizations and death. An influenza outbreak can interfere with combat readiness in a military setting, as the infection can incapacitate soldiers. Vaccination remains the most effective tool to prevent and mitigate seasonal influenza. Although influenza vaccinations for U.S. Army soldiers can be monitored through military health systems, those systems cannot capture DoD civilians and Army dependents who may not use military health services. This study aims to gauge flu vaccine uptake and perceptions in U.S. Army civilians and dependents. Materials and Methods An online survey was e-mailed to civilian and dependent enrollees of Landstuhl Regional Medical Center. The survey contained 24 questions pertaining to demographics, vaccine history, history of the flu, and beliefs toward vaccines. Chi-square tests, t-tests, and logistic regressions were performed to investigate the association between demographic, behavior, and belief factors with vaccine uptake. Free-text answers were coded and categorized by themes. Results Over 70% of respondents were vaccinated for the flu. There were differences between vaccinated and unvaccinated respondents regarding their perceptions of barriers to vaccination, benefits of the flu vaccine, severity of flu symptoms, and personal risk of getting ill with the flu. After controlling for confounders, flu vaccination in the previous season and healthcare worker status were associated with increased vaccine uptake, while perceived barriers to influenza vaccination were associated with decreased vaccine uptake. Conclusions Flu vaccine uptake may be increased by increasing access to vaccination, promoting vaccination and addressing concerns at the provider level, and engaging positively framed public messaging. Increasing flu vaccine uptake is of particular importance as the flu season approaches during the COVID-19 (Coronavirus disease 2019) pandemic.

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Utility of Natural Language Processing for Clinical Quality Measures Reporting

Online Journal of Public Health Informatics ◽

10.5210/ojphi.v9i1.7605 ◽

2017 ◽

Vol 9 (1) ◽

Author(s):

Dino P. Rumoro ◽

Shital C. Shah ◽

Gillian S. Gibbs ◽

Marilyn M. Hallock ◽

Gordon M. Trenholme ◽

...

Keyword(s):

Health Care ◽

Natural Language Processing ◽

Natural Language ◽

Language Processing ◽

Medical Center ◽

Academic Medical Center ◽

Quality Measures ◽

Surveillance Program ◽

Free Text ◽

Influenza Immunization

ObjectiveTo explain the utility of using an automated syndromic surveillanceprogram with advanced natural language processing (NLP) to improveclinical quality measures reporting for influenza immunization.IntroductionClinical quality measures (CQMs) are tools that help measure andtrack the quality of health care services. Measuring and reportingCQMs helps to ensure that our health care system is deliveringeffective, safe, efficient, patient-centered, equitable, and timely care.The CQM for influenza immunization measures the percentage ofpatients aged 6 months and older seen for a visit between October1 and March 31 who received (or reports previous receipt of) aninfluenza immunization. Centers for Disease Control and Preventionrecommends that everyone 6 months of age and older receive aninfluenza immunization every season, which can reduce influenza-related morbidity and mortality and hospitalizations.MethodsPatients at a large academic medical center who had a visit toan affiliated outpatient clinic during June 1 - 8, 2016 were initiallyidentified using their electronic medical record (EMR). The 2,543patients who were selected did not have documentation of influenzaimmunization in a discrete field of the EMR. All free text notes forthese patients between August 1, 2015 and March 31, 2016 wereretrieved and analyzed using the sophisticated NLP built withinGeographic Utilization of Artificial Intelligence in Real-Timefor Disease Identification and Alert Notification (GUARDIAN)– a syndromic surveillance program – to identify any mention ofinfluenza immunization. The goal was to identify additional cases thatmet the CQM measure for influenza immunization and to distinguishdocumented exceptions. The patients with influenza immunizationmentioned were further categorized by GUARDIAN NLP intoReceived, Recommended, Refused, Allergic, and Unavailable.If more than one category was applicable for a patient, they wereindependently counted in their respective categories. A descriptiveanalysis was conducted, along with manual review of a sample ofcases per each category.ResultsFor the 2,543 patients who did not have influenza immunizationdocumentation in a discrete field of the EMR, a total of 78,642 freetext notes were processed using GUARDIAN. Four hundred fiftythree (17.8%) patients had some mention of influenza immunizationwithin the notes, which could potentially be utilized to meet the CQMinfluenza immunization requirement. Twenty two percent (n=101)of patients mentioned already having received the immunizationwhile 34.7% (n=157) patients refused it during the study time frame.There were 27 patients with the mention of influenza immunization,who could not be differentiated into a specific category. The numberof patients placed into a single category of influenza immunizationwas 351 (77.5%), while 75 (16.6%) were classified into more thanone category. See Table 1.ConclusionsUsing GUARDIAN’s NLP can identify additional patients whomay meet the CQM measure for influenza immunization or whomay be exempt. This tool can be used to improve CQM reportingand improve overall influenza immunization coverage by using it toalert providers. Next steps involve further refinement of influenzaimmunization categories, automating the process of using the NLPto identify and report additional cases, as well as using the NLP forother CQMs.Table 1. Categorization of influenza immunization documentation within freetext notes of 453 patients using NLP

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2009 H1N1 and Seasonal Influenza Immunization Among Pregnant Women: A Comparison of Different Sources of Immunization Information

Maternal and Child Health Journal ◽

10.1007/s10995-013-1293-y ◽

2013 ◽

Vol 18 (3) ◽

pp. 681-687 ◽

Cited By ~ 2

Author(s):

Bonny Specker ◽

Betty Wey ◽

Jill Fuller ◽

Marie-Noel Sandoval ◽

Maureen Durkin ◽

...

Keyword(s):

Pregnant Women ◽

Seasonal Influenza ◽

Influenza Immunization ◽

2009 H1n1 ◽

Different Sources

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Healthcare personnel absenteeism, presenteeism, and staffing challenges during epidemics

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.453 ◽

2020 ◽

pp. 1-4

Author(s):

Douglas W. Challener ◽

Laura E. Breeher ◽

JoEllen Frain ◽

Melanie D. Swift ◽

Pritish K. Tosh ◽

...

Keyword(s):

Seasonal Influenza ◽

Medical Center ◽

Academic Medical Center ◽

The United States ◽

Healthcare Personnel ◽

Linear Regression Models ◽

Influenza Like Illness ◽

Healthcare Workforce ◽

Academic Medical ◽

Hourly Employees

Abstract: Objective: Presenteeism is an expensive and challenging problem in the healthcare industry. In anticipation of the staffing challenges expected with the COVID-19 pandemic, we examined a decade of payroll data for a healthcare workforce. We aimed to determine the effect of seasonal influenza-like illness (ILI) on absences to support COVID-19 staffing plans. Design: Retrospective cohort study. Setting: Large academic medical center in the United States. Participants: Employees of the academic medical center who were on payroll between the years of 2009 and 2019. Methods: Biweekly institutional payroll data was evaluated for unscheduled absences as a marker for acute illness-related work absences. Linear regression models, stratified by payroll status (salaried vs hourly employees) were developed for unscheduled absences as a function of local ILI. Results: Both hours worked and unscheduled absences were significantly related to the community prevalence of influenza-like illness in our cohort. These effects were stronger in hourly employees. Conclusions: Organizations should target their messaging at encouraging salaried staff to stay home when ill.

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Vaccine-critical videos on YouTube and their impact on medical students’ attitudes about seasonal influenza immunization: A pre and post study

Vaccine ◽

10.1016/j.vaccine.2012.03.074 ◽

2012 ◽

Vol 30 (25) ◽

pp. 3763-3770 ◽

Cited By ~ 28

Author(s):

Pierre Robichaud ◽

Steven Hawken ◽

Leslie Beard ◽

Dante Morra ◽

George Tomlinson ◽

...

Keyword(s):

Medical Students ◽

Seasonal Influenza ◽

Influenza Immunization ◽

Students Attitudes

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Vaccination of Poultry Workers: Delivery and Uptake of Seasonal Influenza Immunization

Zoonoses and Public Health ◽

10.1111/j.1863-2378.2009.01315.x ◽

2011 ◽

Vol 58 (2) ◽

pp. 126-130

Author(s):

R. Vivancos ◽

D. Showell ◽

B. Keeble ◽

S. Goh ◽

M. Kroese ◽

...

Keyword(s):

Seasonal Influenza ◽

Influenza Immunization ◽

Poultry Workers

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Factors associated with seasonal influenza immunization in people with chronic diseases

Medicinski podmladak ◽

10.5937/mp72-31846 ◽

2021 ◽

Vol 72 (2) ◽

pp. 19-25

Author(s):

Slađana Arsenović ◽

Tatjana Gazibara

Keyword(s):

Health Care ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Chronic Diseases ◽

Health Care System ◽

Vaccination Coverage ◽

Seasonal Influenza ◽

Seasonal Influenza Vaccination ◽

Influenza Immunization ◽

Factors Associated

Annually, at a global level, 3 to 5 million people present severe clinical forms of seasonal influenza and up to 650 000 people die of influenza-related complications. People with chronic diseases, such as cardiovascular, pulmonary, renal, hepatic, neurologic, hematologic and metabolic diseases or those reciveing immunosuppressive therapy, constitute a high-risk population group for the development of influenza-related complications, more severe clinical course and poorer health-related outcomes. Due to all of the above, people with chronic diseases are of high priority to receive the influenza vaccine. Immunization represents the key strategy to prevent influenza both in terms of effectiveness and health care costs. Based on the World Health Organization (WHO) recommendations, adequate seasonal influenza immunization coverage among people with chronic diseases is set at 75%. However, few countries achieve this threshold. Understanding predictive factors of vaccination, at different levels of health care delivery (such as individuals, service providers, health policy), is essential to secure acceptance of influenza immunization and achieve the recommended level of vaccination coverage. In this mini review, all the available evidence regarding seasonal influenza vaccination coverage is summarized, alongside factors associated with vaccine uptake in people with chronic diseases as a whole, as well as according to specific diseases such as: cardiovascular and pulmonary disorders, diabetes and cancer. Based on the reviewed empirical evidence, a wide spectrum of factors associated with immunization against influneza was found in people who have chronic diseases. Although diverse, these factors can be systematized into 4 distinctive groups: socio-demographic characteristics, individual attitudes and beliefs, health promoting behaviors and factors related to the health care system. Further efforts are needed to improve the seasonal influenza vaccination coverage. The immunization strategy needs to include the health care system and the community to support people with chronic diseases to continously accept the influenza vaccine.

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Recent Trends and Characteristics Associated with Influenza Vaccination Disparities among Texas Children

10.31235/osf.io/8mnwv ◽

2016 ◽

Author(s):

Lloyd B Potter ◽

Corey Sparks ◽

Bradley Pollock

Keyword(s):

Health Care ◽

Ethnic Differences ◽

Access To Health Care ◽

Seasonal Influenza ◽

Immunization Coverage ◽

White Children ◽

Racial And Ethnic Differences ◽

Influenza Immunization ◽

Access To Health ◽

Using Data

Adequate immunization of children protects them common infections and may serve as an indicator of access to health care. Racial and ethnic differentials in immunization of children may suggest differentials in access to health care. This research describes racial and ethnic differences in childhood influenza immunization coverage and identifies social and economic characteristics associated with these immunization differentials in Texas.Methods: Using data from the National Immunization Survey racial and ethnic differences in seasonal influenza immunization among children is examined as related to social and economic characteristics of children in Texas over the period of 2004 to 2013.Results: Findings suggest the presence of expected differences in childhood seasonal influenza immunization for Hispanic and non-Hispanic black children compared to non- Hispanic white children. Education and marital status of the mother are predictors of influenza immunization as is participation in WIC.Conclusions: Implications of findings suggest the need for qualitative research to better understand barriers to immunization that differentially affect minority children in Texas. Addressing racial and ethnic immunization differentials among children may potentially result in reductions in other racial and ethnic health disparities as they age.

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