Abstract
Background
Influenza morbidity and mortality remain high in the United States although vaccination
clearly improves health outcomes and reduces health expenditures. This study was designed
to assess the effectiveness of mail and telephone reminder strategies on improving
existing clinic influenza vaccination rates among those not seeking early seasonal
vaccination.
Methods
In mid-November, we randomized 1371 patients at a hypertension clinic into 1 of 2
intervention groups, a mail reminder group (letter plus the Centers for Disease Control
[CDC] Influenza Vaccine Information Statement) or a phone reminder group (same information
via a personal phone call), or a control group. The following spring, records were
reviewed for vaccination documentation. Patients without documentation were contacted
by phone to identify whether vaccination for the current season had been obtained.
Results
The final analysis included 884 patients (62% women, mean age 57.2 years old): 325
in the mail reminder group, 246 in the phone reminder group, and 313 represented the
control group. Overall, 388 of these patients (44%) were vaccinated. Vaccination rates
were significantly higher in the intervention groups, 46% for the mail reminder group
(age and sex adjusted odds ratio [OR], 1.8, 95% confidence interval [CI], 1.3-2.5;
P=.001) and 56% for the phone reminder group (OR, 2.8; 95% CI, 1.9-4.0; P<.0001), compared to 33% in the control group. Both interventions increased vaccination
rates in all age/sex groups.
Conclusion
In contrast to earlier studies, this intervention occurred later in the influenza
vaccination period excluding those who seek early vaccination and allowing interventions
to target those less likely to receive vaccination. Compared to previous studies demonstrating
only trivial or modest benefits, both mail and phone reminders effectively increased
clinic vaccination rates in our group of patients.
Keywords
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References
- Prevention and control of influenza.MMWR Recomm Rep. 2006; 55: 1-42
- Influenza vaccination as secondary prevention for cardiovascular disease: a science advisory from the American Heart Association/American College of Cardiology.Circulation. 2006; 114: 1549-1553
- Delivery of influenza vaccine to non-elderly persons with cardiovascular disease, with varying national supply of vaccine: a decision analysis.Hum Vaccin. 2005; 1: 217-223
- Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2008.MMWR Recomm Rep. 2008; 57: 1-60
- Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009.MMWR Recomm Rep. 2009; 58: 1-52
- U.S. Department of Health and Human Services: Office of Disease Prevention and Health Promotion–Healthy People 2010.Nasnewsletter. 2000; 15 ([No authors listed.]): 3
- Facilitating influenza and pneumococcal vaccination through standing order programs.MMWR Morb Mortal Wkly Rep. 2003; 52: 68-69
- The effect of universal influenza immunization on antibiotic prescriptions: an ecological study.Clin Infect Dis. 2009; 49: 750-756
- National Influenza vaccination week: November 26-December 7, 2007.MMWR Morb Mortal Wkly Rep. 2007; 56: 1216-1217
- Generalist and subspecialist physicians' knowledge, attitudes, and practices regarding influenza and pneumococcal vaccinations for elderly and other high-risk patients: a nationwide survey.Arch Intern Med. 2001; 161: 2702-2708
- Influenza vaccination of recommended adult populations, U.S., 1989-2005.Vaccine. 2008; 26: 1786-1793
- Interventions to improve influenza, pneumococcal polysaccharide, and hepatitis B vaccination coverage among high-risk adults: a systematic review.Am J Prev Med. 2005; 28: 248-279
- Patient reminder and patient recall systems to improve immunization rates.Cochrane Database Syst Rev. 2005;
- Interventions that increase use of adult immunization and cancer screening services: a meta-analysis.Ann Intern Med. 2002; 136: 641-651
- Improving influenza, pneumococcal polysaccharide, and hepatitis B vaccination coverage among adults aged <65 years at high risk: a report on recommendations of the Task Force on Community Preventive Services.MMWR Recomm Rep. 2005; 54: 1-11
- Mass mailings have little effect on utilization of influenza vaccine among Medicare beneficiaries.Am J Prev Med. 2002; 23: 43-46
- Effect of the frequency of delivery of reminders and an influenza tool kit on increasing influenza vaccination rates among adults with high-risk conditions.Am J Manag Care. 2004; 10: 698-702
- Effect of patient reminder/recall interventions on immunization rates: a review.JAMA. 2000; 284: 1820-1827
- Interventions aimed at improving immunization rates.Cochrane Database Syst Rev. 2002;
Article Info
Publication History
Published online: September 14, 2010
Footnotes
Funding: None.
Conflict of Interest: None of the authors have any conflicts of interest associated with the work presented in this manuscript.
Authorship: All authors had access to the data and played a role in writing this manuscript.
Identification
Copyright
© 2010 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Improving Influenza Vaccination Rates by Targeting Individuals not Seeking Early Seasonal VaccinationThe American Journal of MedicineVol. 124Issue 9
- PreviewIt was fascinating to read the article “Improving Influenza Vaccination Rates by Targeting Individuals Not Seeking Early Seasonal Vaccination,” by Minor et al.1 This is an excellent clinical research study highlighting the importance of preventative care. Nonadherence is a major barrier to health care interventions, resulting in increased morbidity and reduced quality of life.2
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