Increasing rates of influenza vaccination during pregnancy: a multisite interventional study.
BACKGROUND
Pregnancy is a high-risk indication for influenza vaccination; however, rates of vaccination fall short of Centers for Disease Control and Prevention-recommended guidelines.


METHODS
Brief educational sessions with family physicians and obstetricians were undertaken in the fall of 2002. Notes reading "Think Flu Vaccine" were placed on active obstetric charts during the study period. Charts were reviewed at the end of influenza season for documentation of discussion or administration of influenza vaccination. Charts for the same period during the previous 2 years were also reviewed for baseline.


RESULTS
Baseline rates of vaccination or discussion averaged 1.5% over the 2000-2002 influenza seasons. After intervention, the 2002-2003 rate of vaccination or discussion demonstrated an almost 15-fold increase to 21.9%. This was greater in family practices (3.2% to 44.9%) versus obstetric practices (1.2% to 19.4%), and in small (3.3% to 46.7%) versus large (1.1% to 16%) practices (all values were P < .001).


CONCLUSIONS
Provider education with simple chart prompts seems an effective way to increase rates of physician discussion of influenza vaccination with pregnant women. The increased rates seen in this study across various practice settings also suggest that inclusion of influenza vaccination on standardized prenatal care flowsheets may achieve similar goals with less individualized effort and should be considered.
Wallis
David H
DH
South Bay Family Medical Group, Torrance, CA, USA.
Chin
Jennifer L
JL
Sur
Denise K C
DK
Lee
Michael Y
MY
D000328:Adult; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control*; D009774:Obstetrics / Q000706:statistics & numerical data; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control; D011320:Primary Health Care / Q000706:statistics & numerical data; D011446:Prospective Studies; D016312:Treatment Refusal / Q000706:statistics & numerical data; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult
D007252:Influenza Vaccines