Improving influenza vaccination coverage among high-risk patients: a role for computer-supported prevention strategy?

Abstract Background Seasonal influenza remains a major cause of morbidity and mortality in the USA. Despite the US Centers for Disease Control and Prevention recommendation promoting the early antiviral treatment of high-risk patients, treatment coverage remains low. Methods To evaluate the population-level impact of increasing antiviral treatment timeliness and coverage among high-risk patients in the USA, we developed an influenza transmission model that incorporates data on infectious viral load, social contact, and healthcare-seeking behavior. We modeled the reduction in transmissibility in treated individuals based on their reduced daily viral load. The reduction in hospitalizations following treatment was based on estimates from clinical trials. We calibrated the model to weekly influenza data from Texas, California, Connecticut, and Virginia between 2014 and 2019. We considered in the baseline scenario that 2.7–4.8% are treated within 48 h of symptom onset while an additional 7.3–12.8% are treated after 48 h of symptom onset. We evaluated the impact of improving the timeliness and uptake of antiviral treatment on influenza cases and hospitalizations. Results Model projections suggest that treating high-risk individuals as early as 48 h after symptom onset while maintaining the current treatment coverage level would avert 2.9–4.5% of all symptomatic cases and 5.5–7.1% of all hospitalizations. Geographic variability in the effectiveness of earlier treatment arises primarily from variabilities in vaccination coverage and population demographics. Regardless of these variabilities, we found that when 20% of the high-risk individuals were treated within 48 h, the reduction in hospitalizations doubled. We found that treatment of the elderly population (> 65 years old) had the highest impact on reducing hospitalizations, whereas treating high-risk individuals aged 5–19 years old had the highest impact on reducing transmission. Furthermore, the population-level benefit per treated individual is enhanced under conditions of high vaccination coverage and a low attack rate during an influenza season. Conclusions Increased timeliness and coverage of antiviral treatment among high-risk patients have the potential to substantially reduce the burden of seasonal influenza in the USA, regardless of influenza vaccination coverage and the severity of the influenza season.

Download Full-text

Limits of the Social Benefit Motive Among High-risk Patients: a Field Experiment on Influenza Vaccination Behaviour

Case Medical Research ◽

10.31525/ct1-nct04230343 ◽

2020 ◽

Author(s):

Keyword(s):

High Risk ◽

Field Experiment ◽

Influenza Vaccination ◽

Social Benefit ◽

High Risk Patients ◽

The Social ◽

Risk Patients

Download Full-text

Limits of the social-benefit motive among high-risk patients: a field experiment on influenza vaccination behaviour

BMC Public Health ◽

10.1186/s12889-020-8246-3 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Ozan Isler ◽

Burcu Isler ◽

Orestis Kopsacheilis ◽

Eamonn Ferguson

Keyword(s):

High Risk ◽

Field Experiment ◽

Influenza Vaccination ◽

Social Benefit ◽

High Risk Patients ◽

The Social ◽

Risk Patients

Download Full-text

Vaccinating High-Risk Pediatric Patients and Their Families in the Hospital Setting: Give It a Shot!

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.758 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S322-S323

Author(s):

Rebecca Barros ◽

Wendi Gornick ◽

M Tuan Tran ◽

Beth Huff ◽

Jasjit Singh

Keyword(s):

High Risk ◽

Influenza Vaccine ◽

Influenza Vaccination ◽

Vaccination Rate ◽

Influenza Vaccines ◽

Hospitalized Children ◽

Care Hospital ◽

Vaccine Administration ◽

High Risk Patients ◽

Risk Patients

Abstract Background Hospitalization and hospital-based clinics confer an opportunity to target high-risk patients and their families who would benefit from vaccination. Methods CHOC Children’s Hospital is a tertiary-care hospital in Southern California with 11,995 admissions in 2016, including 1,580 hematology/oncology (HO) admissions. We examined the trend in influenza vaccine administration in hospitalized and HO patients over the last decade. We assessed the trend in Tdap and influenza vaccine administration among parents of hospitalized children. We correlated those trends with disease outbreaks in the community and educational and programmatic efforts at our institution. Results After educational efforts, the influenza vaccination rate in 2017 compared with 2006 increased 13-fold in hospitalized patients and increased 9-fold among hospitalized HO patients. During the H1N1 pandemic in 2009, influenza vaccination rates increased 470% from the year prior (Figure 1). The number of influenza vaccines administered in the clinic to HO patients was 494 and 408 in 2015–2016 and 2016–2017, respectively. Following program initiation, the number of Tdap vaccines administered to parents during their child’s hospitalization increased from 57 doses in 2013 to 118 doses in 2016. The trend in vaccination roughly followed pertussis outbreak cases (Figure 2). The number of influenza vaccines administered to parents of HO patients during their child’s clinic visit increased from 44 doses given in 2015–2016 to 306 doses given in 2016–2017 (Figure 3). At our institution, among staff we achieved a 98% vaccination rate for Tdap and influenza in 2017. There were no serious adverse events reported after patient, parent or staff vaccination during this time period. Conclusion Missed opportunities for vaccination of high-risk children include hospitalization and specialty clinic visits. Creating a culture of vaccination and public perception of vaccine importance during outbreaks can increase the influenza vaccination rate among high-risk, hospitalized and HO patients. Programs targeting families of high-risk patients are an opportunity to cocoon a vulnerable population. Vaccination of hospitalized children, their parents and staff is safe in these settings. Disclosures All authors: No reported disclosures.

Download Full-text