scholarly journals Factors Associated with Influenza & Tdap Vaccine Uptake in Pregnant Patients at the UT Family Medicine Clinic in Memphis

2021 ◽  
Author(s):  
Rachel Woods ◽  
Alison Zhong ◽  
Madelyn Vincent
Keyword(s):  
High Risk ◽  
Vaccine Uptake ◽  
Prenatal Visit ◽  
Vaccination Rates ◽  
Factors Associated ◽  
Significant Relationships ◽  
Tdap Vaccine ◽  
Flu Vaccine ◽  
Flu Shot ◽  
Prenatal Visits

INTRODUCTION: Given the increased risk for infections among pregnant patients and newborns, vaccination against influenza (>50,000,000 annual US cases affecting all ages) and pertussis (>15,000 annual US cases disproportionately affecting newborns) are recommended among pregnant patients in order to protect them and their babies via passive immunity to cover a newborn’s window of vaccine ineligibility. Though flu and Tdap vaccination rates among pregnant patients have been trending upwards nationally, there is still room for improvement to achieve optimal rates. OBJECTIVES: The primary objectives were to study factors that affect the vaccination rates at the University of Tennessee Family Medicine Clinic at Memphis (UTFMC-M), compare those rates with national pregnancy flu/Tdap vaccination rates, and to generate recommendations based off observed factors associated with vaccine uptake to improve flu/Tdap vaccination rates in UTFMC-M pregnant patients. METHODS: This was a retrospective chart review of UTFMC-M patients who were pregnant from September 1, 2019-April 24, 2020 (included 2019-2020 flu season) (n=465). Variables studied included demographic data (race, age, insurance), immunization history (vaccine status, history of physician encouragement), and prenatal history (parity, number of prenatal visits, trimester at first visit, high risk clinic (HRC) admittance status). Vaccination status was based on ACIP recommendations (Flu shot eligible = any gestational age; Tdap eligible = ≥27 weeks). Positive HRC admittance was noted for patients with ≥2 visits to the UTFMC-M HRC, a clinic that specializes in high risk pregnant patient care. RESULTS: The patient sample was predominantly black (84.3%) and insured by Medicaid programs (88%). Among eligible UTFMC-M pregnant patients, 50.1% were flu-vaccinated (n=465); 73.8% were Tdap-vaccinated (n=317); and 52.1% were Flu+Tdap-vaccinated (n=317). No significant associations were found between vaccine uptake and HRC status, parity, and age. However, statistically significant relationships were found between vaccine uptake and physician encouragement (positive relationship with flu shot: X2(1, N = 465) =131, p < 0.001, Tdap: X2 (6, N = 465) =476, p < 0.001), number of prenatal visits (flu shot group median 8 visits, Tdap group median 9 visits vs. unvaccinated group median 4 visits; p < 0.001), and early trimester age at first prenatal visit (X2(6, N = 465) =47.635 , p CONCLUSION: 2019-2020 UTFMC-M vaccination rates were on par with 2018-2019 US flu vaccine rates and higher than 2018-2019 US Tdap and Flu+Tdap rates. There were statistically significant relationships between vaccine uptake at UTFMC-M and physician encouragement, number of prenatal visits, and early trimester age at first prenatal visit but no significant relationships with UTFMC-M HRC admittance, parity, or age. Recommendations following from our observations to address further vaccine rate improvement include: continue vaccine encouragement, continue booking multiple visits (8 for flu, 9 for Tdap), prioritize Tdap vaccine higher for late trimester intake patients, and focus on flu vaccine encouragement and education.

scholarly journals 1755. Assessment of Vaccine Rates in Solid-Organ Transplant Recipients and Identification of factors Associated with Completion of Vaccination

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S644-S645
Author(s):  
Tommy J Parraga Acosta ◽  
Zachary W Hanna ◽  
Nicholas J Daering ◽  
Amit T Vahia ◽  
George J Alangaden
Keyword(s):  
Univariate Analysis ◽  
Organ Transplant ◽  
Solid Organ Transplant ◽  
Vaccine Uptake ◽  
Smoking History ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Vaccination Rates ◽  
Factors Associated ◽  
Solid Organ Transplant Recipients

Abstract Background Vaccine administration is an essential component of pre and post-transplant care. Although Society guidelines for vaccination of solid-organ transplant recipients (SOT) are published, rates of vaccination remain low and potential factors influencing these rates are not well identified. Methods A retrospective review of electronic medical records (EMR) was done for all adult SOT patients who underwent transplantation from January 2015 to December 2016 at Henry Ford Hospital, Detroit, MI. Sociodemographic data, comorbidities, and vaccination status at 1-year post-SOT for influenza, pneumococcus, hepatitis A and B, Tdap, and Td vaccines were assessed from EMR and the Michigan Care Improvement Registry. Data were analyzed using SAS 9.4 software, univariate analysis was done with Chi-square test, t-test, and multivariate analysis with logistic regression. Results 530 patients underwent SOT during the study period. Characteristics of the study population are shown (Table 1). The median age was 59, mean Charlson Comorbidity Index was 5.25, 58.3% had smoking history. At 1-year post SOT, 88.7% had received ≥1 vaccine(s), whereas 11.3% received no vaccines. Most patients received vaccines before SOT. Influenza (69.4%) and pneumococcal (69.3%) vaccines were the most administered (Table 2). On univariate analysis, pre-SOT visits with a primary care provider (PCP), transplant team or PCP based at our institution were significantly associated with vaccination (Table 3). On multivariate analysis, PCP based at our institution (odds ratio [OR], 2.03 [95% confidence interval {CI}, [1.06–3.88], P = 0.033) and pre-SOT PCP visits (OR 1.47, [95% CI 1.11–1.96], P = 0.008) were significantly associated with vaccine uptake. Smoking history negatively impacted vaccine uptake (Table 4). Patients who had received the influenza vaccine(s) were significantly associated with increased uptake of other vaccines (P < 0.0001). Conclusion Despite guidelines, vaccination rates in SOT patients remain low at our institution. Factors associated with improved vaccination were institution-based PCP, pre-SOT PCP visits and receipt of influenza vaccines. A multidisciplinary approach is required for the optimization of vaccination rates in the SOT population. Disclosures All authors: No reported disclosures.

scholarly journals Improving pneumococcal vaccine uptake in veterans with chronic lymphocytic leukemia through a virtual clinic

2018 ◽  
Vol 25 (1) ◽  
pp. 95
Author(s):  
E.C. Church ◽  
R. Banks ◽  
B. Wilson ◽  
L. Arfons ◽  
F. Perez ◽  
...  
Keyword(s):  
High Risk ◽  
Chronic Lymphocytic Leukemia ◽  
Medical Record ◽  
Pneumococcal Vaccine ◽  
High Risk Patient ◽  
Lymphocytic Leukemia ◽  
Vaccine Uptake ◽  
Pneumococcal Vaccines ◽  
Vaccination Rates ◽  
Virtual Clinic

Through a “virtual clinic,” we used the electronic medical record to identify and intervene upon patients with chronic lymphocytic leukemia (cll) who were not current for pneumococcal vaccines. Within 180 days, 100/160 patients (62%) received the recommended pneumococcal vaccine. A virtual clinic may improve vaccination rates among high-risk patient populations.

scholarly journals Association of Tdap vaccine guidelines with vaccine uptake during pregnancy

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254863
Author(s):  
Julia D. DiTosto ◽  
Rebecca E. Weiss ◽  
Lynn M. Yee ◽  
Nevert Badreldin
Keyword(s):  
Influenza Vaccine ◽  
Pneumococcal Vaccine ◽  
Vaccine Uptake ◽  
Influenza Vaccines ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Before And After ◽  
Tdap Vaccine ◽  
To Receive ◽  
Hispanic White

Objective In 2012, recommendations for universal tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccination during pregnancy were released. Our objective was to determine if Tdap, influenza, and pneumococcal vaccine uptake during pregnancy changed after the release of the guidelines, and identify factors associated with receiving the Tdap and influenza vaccine after 2012. Methods We conducted a retrospective cohort study on pregnant individuals who initiated prenatal care before 20 weeks’ gestation between 11/2011-11/2012 (“pre-guideline”) and 12/2012-12/2015 (“post-guideline”). Vaccine uptake dates were abstracted from medical records. The pre and post-guideline cohorts were compared to determine if Tdap vaccine uptake and timing improved after the new Tdap guidelines. We additionally examined influenza and pneumococcal vaccine uptake before and after guidelines. Factors associated with receipt of the Tdap and influenza vaccine during pregnancy in the post-guideline cohort were evaluated using multivariable logistic regression models. Results Of 2,294 eligible individuals, 1,610 (70.2%) received care in the post-guideline cohort. Among the pre-guideline cohort, 47.4% received Tdap, whereas Tdap uptake increased to 86.1% after the guidelines (p<0.001). Similarly, receiving the Tdap vaccine between the recommended time of 27–36 weeks gestational age improved from 52.5% to 91.8% after the guidelines (p<0.001). Vaccine frequency for influenza improved significantly from 61.2% to 72.0% (p<0.001), while frequency for pneumococcus were low and unchanged. An increased number of prenatal visits was associated with receiving the Tdap and influenza vaccines during pregnancy (respective, aOR 1.09 95% CI 1.05–1.13; aOR 1.50 95% CI 1.17–1.94). Non-Hispanic Black individuals were less likely to receive both the Tdap and influenza vaccines during pregnancy compared to non-Hispanic White individuals (respective, aOR 0.51 95% CI 0.33–0.80; aOR 0.68 95% CI 0.48–0.97). Conclusions Receipt and timing of Tdap vaccine improved after implementation of the 2012 ACIP guidelines. Receipt of influenza vaccine uptake also improved during the study period, while uptake of the pneumococcal vaccine remained low. Significant racial disparities exist in receipt of Tdap and influenza vaccine during pregnancy.

scholarly journals Uptake of Covid–19 vaccines among frontline workers in California state prisons

2021 ◽  
Author(s):  
Lea Prince ◽  
Elizabeth Long ◽  
David Studdert ◽  
David Leidner ◽  
Elizabeth T Chin ◽  
...  
Keyword(s):  
Vaccine Uptake ◽  
Healthcare Staff ◽  
California Department ◽  
Prison Staff ◽  
Frontline Staff ◽  
Frontline Workers ◽  
Vaccination Rates ◽  
Factors Associated ◽  
Risk Environments ◽  
State Prisons

Background Prisons are high–risk environments for Covid–19. Vaccination levels among prison staff remain troublingly low – lower than levels among residents and members of the surrounding community. The situation is troubling because prison staff are a key vector for Covid–19 transmission. Objective To assess patterns and timing of staff vaccination in California state prisons and identify individual– and community–level factors associated with being unvaccinated. Design We calculated fractions of prison staff and incarcerated residents in California state prisons who remained unvaccinated. Adjusted analyses identified demographic, community, and peer factors associated with vaccination uptake among staff. Setting California Department of Corrections and Rehabilitation prisons. Participants Custody and healthcare staff who worked in direct contact with residents. Main Outcomes and Measures Remaining unvaccinated through June 30, 2021. Results A total of 26 percent of custody staff and 52 percent of healthcare staff took ≥ 1 dose in the first two months of vaccine offer; uptake stagnated thereafter. By June 30, 2021, 61 percent of custody and 37 percent of healthcare staff remained unvaccinated. Remaining unvaccinated was positively associated with younger age, prior Covid–19, residing in a community with relatively low vaccination rates, and sharing shifts with co–workers who had relatively low vaccination rates. Conclusions and Relevance Vaccine uptake among prison staff in California in regular contact with incarcerated residents has plateaued at levels that pose ongoing risks – both of further outbreaks in the prisons and transmission into surrounding communities. Staff decisions to forego vaccination appear to be complex and multifactorial. Achieving safe levels of vaccine protection among frontline staff may necessitate requiring vaccination as condition of employment.

scholarly journals 2735. Improving Uptake of Maternal Immunizations in the Obstetric Care Setting Through an Adaptation of the CDC’s Immunization Quality Improvement Program (AFIX)

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S962-S963
Author(s):  
Sean T OLeary ◽  
Mallory Ellingson ◽  
Christine Spina ◽  
Sarah E Brewer ◽  
Lori Quick ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Private Insurance ◽  
Obstetric Care ◽  
Vaccine Uptake ◽  
Post Intervention ◽  
Improvement Program ◽  
Vaccination Rates ◽  
Immunization Rates ◽  
Study Staff ◽  
Tdap Vaccine

Abstract Background Influenza and Tdap vaccines are recommended for pregnant women in every pregnancy. However, vaccine uptake remains suboptimal. Obstetrics practices need quality improvement models to improve their vaccination delivery programs. CDC’s AFIX program has been shown to be effective at increasing vaccination uptake in primary care settings. Our objective was to adapt and evaluate CDC’s AFIX program in the obstetrical setting (AFIIX-OB). Methods An average of 40 charts per practice were randomly reviewed pre- and post-intervention. Baseline immunization rates and vaccine administration practices were collected in the Assessment phase. Feedback was provided at meetings conducted by study staff where baseline immunization rates were shared and practices selected quality improvement measures to implement. Practices were required to implement either standing orders for influenza and Tdap vaccines or improve their vaccine documentation. As an Incentive, providers could receive continuing medical education and maintenance of certification part IV credit. After implementing the practice specific measures for 6 months, practice-wide vaccine rates were assessed and a post-intervention meeting was held with providers and staff at each practice to eXchange the results. Results AFIX-OB was implemented in 11 obstetric practices: 5 in Georgia and 6 in Colorado. Practices were primarily urban, their patients largely Caucasian and African American and most patients carried private insurance. Baseline practice-level immunization rates ranged from 10% to 82.9% for influenza vaccine and 12.5% to 97.6% for Tdap. 4 practices implemened standing orders, 6 improved their vaccine documentation and 1 did both. After the 6 month follow-up period, all 11 practices saw improvements in their overall Tdap vaccine acceptance (3 with statistically significant increases, P < 0.05) with final rates ranging from 25% to 100%. 9 practices either maintained or improved their influenza vaccination rates (4 with statistically significant increases, P < 0.05) with final rates ranging from 32.5% to 85.0%. Conclusion The AFIX-OB model provides a promising intervention to improve maternal immunization uptake that can be administered widely but still be tailored to the needs of individual clinics. Disclosures All authors: No reported disclosures.

scholarly journals Informing patients that they are at high risk for serious complications of viral infection increases vaccination rates

2021 ◽  
Author(s):  
Maheen Shermohammed ◽  
Amir Goren ◽  
Alon Lanyado ◽  
Rachel Yesharim ◽  
Donna M. Wolk ◽  
...  
Keyword(s):  
High Risk ◽  
Medical Records ◽  
Direct Mail ◽  
Vaccine Uptake ◽  
Algorithm Analysis ◽  
Control Group ◽  
Patient Portal ◽  
Computer Algorithms ◽  
Post Intervention ◽  
Vaccination Rates

AbstractFor many vaccine-preventable diseases like influenza, vaccination rates are lower than optimal to achieve community protection. Those at high risk for infection and serious complications are especially advised to be vaccinated to protect themselves. Using influenza as a model, we studied one method of increasing vaccine uptake: informing high-risk patients, identified by a machine learning model, about their risk status. Patients (N=39,717) were evenly randomized to (1) a control condition (exposure only to standard direct mail or patient portal vaccine promotion efforts) or to be told via direct mail, patient portal, and/or SMS that they were (2) at high risk for influenza and its complications if not vaccinated; (3) at high risk according to a review of their medical records; or (4) at high risk according to a computer algorithm analysis of their medical records. Patients in the three treatment conditions were 5.7% more likely to get vaccinated during the 112 days post-intervention (p < .001), and did so 1.4 days earlier (p < .001), on average, than those in the control group. There were no significant differences among risk messages, suggesting that patients are neither especially averse to nor uniquely appreciative of learning their records had been reviewed or that computer algorithms were involved. Similar approaches should be considered for COVID-19 vaccination campaigns.

scholarly journals A Quality Improvement Project to Improve Influenza Vaccination Rates Among Employees at an Onsite Employer-Based Health Clinic

2021 ◽  
pp. 216507992110169
Author(s):  
Karen Landwehr ◽  
W. Jeff Trees ◽  
Susan Reutman
Keyword(s):  
Quality Improvement ◽  
The United States ◽  
Quality Improvement Project ◽  
Vaccine Uptake ◽  
Health Clinic ◽  
Full Time ◽  
Improvement Project ◽  
Vaccination Rates ◽  
Number Of Patients ◽  
Flu Vaccine

Background In the United States, millions of people contract the flu each year. Immunization has been shown to provide the best protection against the flu. Increasing flu vaccination rates can reduce the number of patients who get the flu and seek care for non-specific symptoms thus making detection of the coronavirus more efficient. Method A quality improvement project was implemented to increase the number of influenza vaccines received by employees at an onsite employer-based health clinic. Anonymous pre- and post-surveys were used to assess the flu knowledge of employees. Employees from a large financial group, who voluntarily participated, received an educational handout at the onsite health fair or at a lunch and learn. Full-time employees who carried their employer’s health insurance were eligible to participate, whereas, dependents and contract employees were excluded. Findings The number of employees who received the vaccination increased during the fall of 2019 ( n = 406) when compared with the previous year ( n = 337). Nineteen percent ( n = 170) of employees completed surveys. There were statistically significantly more post- than pre-survey responses reflecting the participants’ perceived knowledge of influenza and the flu vaccine. The majority of participants in both the pre- and post-surveys reported that they learned “a lot” about both influenza and the flu vaccine. Conclusion Providing education and access to the vaccine in the workplace may improve flu knowledge, reduce barriers, and increase flu vaccine uptake among employees.

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