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Strategies to Improve Influenza Control

Strategies to Improve Influenza Control. Influenza Vaccination Rates of High Risk Adults, NHIS 2003. 2010 Goal. MMWR 2005; 54: 1045. Strategies for Improving Vaccination Coverage. Increase demand Patient reminders / provider recommendation Multifaceted programs including education

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Strategies to Improve Influenza Control

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  1. Strategies to Improve Influenza Control

  2. Influenza Vaccination Rates of High Risk Adults, NHIS 2003 2010 Goal MMWR 2005; 54: 1045.

  3. Strategies for Improving Vaccination Coverage • Increase demand • Patient reminders / provider recommendation • Multifaceted programs including education • Regulation • Enhance access • Reduce cost • Walk-in clinics • Address provider barriers • Reminders / Feedback • Standing orders & policies Task Force on Community Preventive Services MMWR 1999; 48 (RR-8)

  4. Improving vaccination coverage for HR adults < 65 yearsReport on Task Force on Community Preventive Services • Single interventions • Provider recommendations • Combinations of interventions • Enhanced access + • Provider/systems-based interventions &/or • Client reminders / educations MMWR 2005; 54 (RR-5)

  5. Attitudes & Beliefs Regarding Measures to Prevent Influenza & Other Respiratory IllnessesEmerging Infections Program Survey, 2004 Data from CDC survey, 2004. N=2231 surveys from Emerging Infections Program [11 population-based network surveillance areas ]. MMWR 2004; 53: 1156.

  6. Side Effects Associated with Influenza Vaccination in Healthy, Working Adults Nichol KL, et al. Arch Intern Med 1996; 156: 1546.

  7. Provider Recommendation Can Overcome Negative Attitudes Nichol KL. J Gen Intern Med 1996; 11: 673.

  8. Multifaceted Program Improved Success & Sustainability

  9. Success of Standing Orders as Part of a Multifaceted Vaccination Program Nichol. Am J Med 1998; 105: 385.

  10. Standing Orders More Effective than Education or MD Reminders for Inpatients Crouse B, et al. J Fam Pract 1994; 38: 258.

  11. Physicians Often Fail to Use Effective Strategies All P’s < .001 Nichol KL. Arch Intern Med 2001; 161: 2702.

  12. HCW vaccination is an important component of influenza prevention & control

  13. Influenza Vaccination of Health Care Workers, US 2003 (NHIS)

  14. Vaccinations in Nontraditional Settings • Potential advantages • Cost • Access / convenience • Increased public awareness and demand • New providers and new strategies • For flu, pneumo, ??? other vaccines NVAC. Adult Immunization Programs in NTS: Quality Standards & Guidance. MMWR 2000;49 (RR-1).

  15. Kind of Place Where Flu Shots Received, U.S., 1998/99 Source: 1999 Behavioral Risk Factor Surveillance System

  16. Influenza VE in Community Dwelling Elderly (results of 2 meta analyses) Vu T, et al. Vaccine 2002; 20: 1831. Jefferson T, et al. Lancet 2005; 366:1165-74.

  17. Influenza VE in LTCF Elderly(results of 2 meta analyses) Gross PA, et al. Ann Intern Med 1995; 123: 518 – 27. Jefferson TJ, et al. Lancet 2005; 366:1165-74.

  18. Vaccine Effectiveness -- 81% (-101% - 98%) 35% (19% - 47%) -5% (-89% - 42%) 33% (27% - 38%) 27% (15% - 28%) 30% (25% - 35%) 22% (15% - 28%) -- 24% (18% - 30%) 50% (45% - 56%) 47% (39% - 54%) Favors vaccine Favors no vaccine Vu T, et al. Vaccine 2002; 20: 1831. Jefferson T, et al. Lancet 2005; 366:1165-74.

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