title: Response to the 2004-2005 influenza vaccine shortage in veterans with spinal cord injuries and disorders and their providers.
abstract: OBJECTIVE
  To assess patient and provider behaviors regarding influenza vaccination, diagnosis, and testing strategies and the availability of influenza vaccine during the 2004-2005 nationwide influenza vaccine shortage.
  
  
  METHODS
  Multisite, anonymous, cross-sectional surveys of patients and providers and qualitative interviews after the 2004-2005 influenza season.
  
  
  METHODS
  Department of Veterans Affairs (VA) health care facilities with spinal cord injury centers or clinics.
  
  
  METHODS
  Stratified random sample of 3,958 veterans with spinal cord injuries and disorders (SCI & D; 31% response rate), 177 providers who treat persons with SCI&D, and 17 key informants.
  
  
  RESULTS
  Most patient respondents (96.1%) reported awareness of a vaccine shortage (n = 938). When asked whether the shortage affected their ability to get the vaccine, 64.8% said they had no problem, whereas 12.1% reported an inability to get the vaccine. The vaccination rate was 71.8%; most veterans received the vaccine early (October-November) at the VA, and vaccination rates increased with age (P < 0.0001). Although vaccine shortages were reported by 47.5% of provider survey respondents (n = 177), most reported that the vaccine shortage did not affect availability of vaccine for patients with SCI&D. Few clinicians conducted diagnostic tests for influenza more often than in past years (4.9%). Although providers reported shortages at 12 centers (n = 23), patients with SCI&D had priority at 11 of 12 centers.
  
  
  CONCLUSIONS
  Most patients were aware of the vaccine shortage, and the vaccination rate remained high and comparable with previous years. VA providers and facilities targeted SCI&D as a high-risk group and prioritized use of the limited vaccine supply for them.
authors: Department of Veterans Affairs, Spinal Cord Injury Quality Enhancement Research Initiative, Midwest Center for Health Services and Policy Research, Edward Hines Jr. Veterans Affairs Hospital, Hines, Illinois 60141, USA. charlesnika.evans@va.gov
authors: Charlesnika T
authors: CT
authors: Evans
authors: Sherri L
authors: SL
authors: LaVela
authors: Bridget
authors: B
authors: Smith
authors: Carolyn
authors: C
authors: Wallace
authors: Barry
authors: B
authors: Goldstein
authors: Frances M
authors: FM
authors: Weaver
mesh_terms: D000368:Aged; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000600:supply & distribution*; D008297:Male; D008875:Middle Aged; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000276:immunology; D014481:United States; D014728:Veterans / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines