The majority of children with asthma fail to get vaccinated for influenza even when they visit health care providers during the flu season.
Addressing these missed opportunities for vaccination could significantly improve vaccination rates among these children, according to results of a recently published study.
In this retrospective study of 4,358 asthmatic children (aged 5–18 years) in the Michigan Medicaid program, only 17% had a flu vaccination during the 2001–2002 flu season, and only 22% had a flu vaccination during the 2002–2003 season. Less than 10% of children received influenza vaccinations in both seasons, and 71% were not vaccinated in either season (Arch. Pediatr. Adolesc. Med. 2006;160:966–71).
During 2001–2002, 73% of the children had at least one missed opportunity for vaccination, defined as visits during the flu season (October-January) when a vaccine-eligible child is seen by a health care professional, yet no vaccine is administered. During the 2002–2003 flu season, 69% of the children had at least one missed opportunity.
In each of the seasons, close to 50% of the missed opportunities occurred in October, and nearly three-quarters occurred in either October or November.
These figures demonstrate that missed opportunities to vaccinate for influenza are more common than vaccination among these children and frequently occur in successive influenza seasons, said Kevin J. Dombkowski, Dr.P.H., and his colleagues from the University of Michigan, Ann Arbor. They said that their study was the first to look at children with public insurance over successive flu seasons. But the results were similar to earlier studies of privately insured children with asthma, which also found that missed opportunities for flu vaccination abounded.
The investigators calculated that even a modest reduction in missed opportunities could substantially increase influenza vaccination rates. A 25% reduction in missed opportunities would result in an overall 35% vaccination rate among children with asthma, and a 50% reduction in missed opportunities would translate into an overall vaccination rate of 49%.
Dr. Dombkowski and his associates suggested that standing orders and reminder-recall systems could reduce the rate of missed opportunities for vaccination. They urged that emphasis be placed on implementing physician-focused reminder systems, but that reminder systems that prompt parents to request vaccination also may be effective.