Evaluation of an Influenza Vaccination Program in the Pediatric Emergency Department.

Abstract

Objective: To evaluate influenza vaccine administration rate among eligible patients in pediatric emergency departments (ED) following the introduction of a standardized vaccination program.

Study design: We conducted a retrospective study of children ≥6 months of age evaluated in a tertiary care pediatric emergency department (ED) and three affiliated ED sites. Our pre-intervention period was September 2019 through April 2020, and intervention period was September 2020 through April 2023. Our intervention comprised nursing education, standing orders, and a best practice advisory in the electronic health record. Our primary outcome was administration of influenza vaccine in the ED.

Results: There were 51,581 and 144,811 children in the pre-intervention and intervention periods with 64,705 and 172,021 ED encounters, respectively. The intervention increased the odds of vaccination by 15.22 (95% CI 12.39-18.70), from 272 influenza vaccines in the pre-intervention period to 1,892, 2,141, and 755 in the intervention seasons (p < 0.001). During the intervention period, children who received influenza vaccines compared with those who did not were more likely to be older (median 8.5 yrs vs 5.8 yrs), of Black race (8.4% vs 7.2%) or multiple/other race (26.0% vs 19.8%), Hispanic ethnicity (46.0% vs 34.7%), with public insurance (64.3% vs 56.0%), and of lower acuity triage level 4 or 5 (64.2% vs 56.8%), p < 0.001 for all.

Conclusions: Implementation of a standardized influenza vaccination program in the ED can increase vaccination rates, particularly among minority and government-insured children. These interventions can address vaccine disparities and are easily sustainable with potential to reduce the public health burden of influenza.