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Description
Background: Influenza vaccination rates nationally remain much lower than rates for routine pediatric immunizations and leave many children at risk. The delivery of the influenza vaccine presents unique challenges as it requires yearly administration in a short time frame. Although the majority of influenza vaccinations are administered October- December, the peak of cases often occurs in February. The San Diego Influenza Coverage Extension (SD-ICE) study is a two year intervention study that aims to improve influenza vaccination rates using an academic detailing intervention. Academic detailing is a form of continuing medical education for physicians where a health educator conducts a brief seminar on designated topics; in this case immunization. Methods: Parents of children 6-60 months were recruited and interviewed during the 2008-2009 (n=788) influenza season in 6 medical clinics. Intervention clinics received an academic detailing visit from the study staff medical director who discussed clinic immunization rates and promoted the adoption of selected evidence based practices to improve immunization rates; including vaccinating during late season. Recruitment and interviewing the follow up year took place during the 2010-2011 (n=717) influenza season. Results: The overall influenza vaccination rate of the intervention group significantly increased by 7.7% (2008-2009: 55.4%, 2010-2011:63.1%, p=0.03) while control group vaccination rates were not significantly different across study years (2008-2009: 73.0%, 2010-2011: 77.4%, p=0.16). However, when placed in a generalized linear model, study year by study group interaction was found to be insignificant (p=0.61). In the follow up year the intervention group experienced a borderline significant increase of 8.5% in late season vaccination rates from baseline (2008-2009: 20.5%, 2010-2011: 28.5%, p=0.05). The control group experienced a 4.4% increase in late season vaccination rates from baseline however, it was not significant (2008-2009: 23.4%, 2010-2011: 27.8% p=0.72). Odds ratios of influenza vaccination for group, private, and community health clinics are not significantly different where p=0.1975. Conclusions: The academic detailing intervention was not successful in increasing childhood influenza vaccinations any more than what naturally occurred from the 2008-2009 to 2010-2011 season. The intervention was minimally successful at increasing late season vaccination in intervention clinics from the 2008-2009 to 2010-2011 influenza season. More intensive methods are required to improve influenza vaccination rates through the use of academic detailing. There are no disparities in vaccination of children less than 5 years old between the major types of medical clinics.
