610 - Evaluation of an Influenza Vaccination Program in the Pediatric Emergency Department Setting

Poster Number: 610
Publication Number: 610.224

Amethyst A. Alayari, Children's Hospital Colorado, Denver, CO, United States; Sonja I. Ziniel, University of Colorado School of Medicine - Department of Pediatrics, Aurora, CO, United States; Joan E. MacKenzie, Children's Hospital Colorado, Boulder, CO, United States; Suchitra Rao, University of Colorado School of Medicine, Aurora, CO, United States

Background: Influenza vaccines are recommended for all children 6 months of age and older during any healthcare visit, but national influenza vaccination rates in children remain low. Emergency department (ED) visits provide an ideal opportunity to provide vaccines, especially to those with limited healthcare access.

Objective:

Evaluate influenza vaccine administration rates among eligible patients in the pediatric emergency department following the introduction of an influenza vaccination program. 

Design/Methods: We conducted a retrospective study of children ≥ 6 months of age evaluated in a large tertiary care pediatric ED and three affiliated community urgent care/EDs. Our pre-intervention period was between September 2019-April 2020, and our intervention period was from September-April between 2020-2022 and September to December 2022. Our intervention comprised of nursing education and incentives, standing orders, and a best-practice advisory in the electronic health record for all eligible patients. Our primary outcome was the number of influenza vaccine administrations in the ED.

Associations between vaccine administrations in the ED and demographic as well as clinical characteristics were assessed using Fisher’s Exact tests for categorical variables and non-parametric equality of median tests for continuous variables.

Results:

There were 61,031 and 151,565 children in the pre- and intervention periods, respectively. In the pre-intervention period, the number (percentage) of influenza vaccines administered for eligible patients in our pediatric emergency departments and urgent care settings was 315 (0.4%), which increased to 2,179 (5%), 2,473 (2.7%) and 739 (1.3%) in the intervention seasons (p < 0.001) (Table 1). Children who received vaccines in the intervention period were more likely to be older in age (median 8.8 yrs vs 5.7 yrs), of Black race (8.5% vs 7.8%), multiple or other races (30.6% vs 24.7%), of Hispanic ethnicity (47.5% vs 36.3%), have primarily Spanish-speaking caregivers (15.6% vs 9.9%), have public insurance (66.4% vs 58.8%), be of lower acuity Triage level 4 or 5 (64.7% vs 50.1%), and have a visit in October (33.4% vs 17.2%), p < 0.001 for all (Table 2).

Conclusion(s):

Implementation of a standardized influenza vaccination program in the pediatric emergency department can increase vaccination rates, particularly among minority and government-insured children. These interventions can address vaccine disparities, are easily sustainable and have the potential to reduce the public health burden of influenza, including hospitalizations and deaths.