Infection Control Today | Published online: 3 November 2016
An evidence-based, step-by-step guide, the 4 Pillars™ Practice Transformation Program, was the foundation of an intervention to increase adult immunizations in primary care and was tested in a randomized controlled cluster trial. The purpose of this study by Lin, et al. (2016) was to report changes in influenza immunization rates and on factors related to receipt of influenza vaccine.
Twenty-five primary care practices were recruited in 2013, stratified by city (Houston, Pittsburgh), location (rural, urban, suburban) and type (family medicine, internal medicine), and randomized to the intervention (n = 13) or control (n = 12) in Year 1 (2013-14). A follow-up intervention occurred in Year 2 (2014-15). Demographic and vaccination data were derived from de-identified electronic medical record extractions.
A cohort of 70,549 adults seen in their respective practices (n = 24 with 1 drop out) at least once each year was followed. Baseline mean age was 55.1 years, 35 % were men, 21 % were non-white and 35 % were Hispanic. After one year, both intervention and control arms significantly (P < 0.001) increased influenza vaccination, with average increases of 2.7 to 6.5 percentage points. In regression analyses, likelihood of influenza vaccination was significantly higher in sites with lower percentages of patients with missed opportunities (P < 0.001) and, after adjusting for missed opportunities, the intervention further improved vaccination rates in Houston (lower baseline rates) but not Pittsburgh (higher baseline rates). In the follow-up intervention, the likelihood of vaccination increased for both intervention sites and those that reduced missed opportunities (P < 0.005).
The researchers say that reducing missed opportunities across the practice increases likelihood of influenza vaccination of adults. The 4 Pillars™ Practice Transformation Program provides strategies for reducing missed opportunities to vaccinate adults.
NICE is developing priorities to help ensure unvaccinated children across the country get the protection they need. In some areas of the country, fewer than 1 in 5 children are vaccinated against diseases such as polio and diphtheria. Experts have warned that unless uptake rates improve there is a risk of these diseases making a comeback.
Two types of flu vaccine are available for children in 2016 to 2017: the ‘live’ nasal spray vaccine and the inactivated injected flu vaccine. An updated flu vaccine chart for children in 2016 to 2017 indicates which vaccine children should get and who is eligible.
Department of Health | First published: 26 August 2016
Using the nasal spray flu vaccine for the UK childhood influenza immunisation programme: advice from JCVI
The Joint Committee on Vaccination and Immunisation (JCVI) has reviewed updated data from the 2015 to 2016 season in the UK and other countries on the effectiveness of the nasal spray vaccine, in light of emerging evidence of low effectiveness of the nasal spray vaccine reported in the United States (US).
This statement sets out the committee’s advice for continuation of the childhood influenza immunisation programme in using the live attenuated influenza vaccine (LAIV, the nasal spray vaccine).