title: Additional visit burden for universal influenza vaccination of US school-aged children and adolescents.
abstract: OBJECTIVE
  To estimate the additional primary care visits needed for universal influenza vaccination of all US children and adolescents if all vaccinations occurred in primary care settings.
  
  
  METHODS
  Cross-sectional design.
  
  
  METHODS
  Well-child care and other visits to primary care practices from the 2003-2004 Medical Expenditure Panel Survey.
  
  
  METHODS
  Children aged 5 to 18 years (n = 3047) with a usual source of care. Main Outcome Measure Percentage of children needing 0, 1, or 2 additional visits to be immunized against influenza in a 3-, 4-, or 5-month vaccination window.
  
  
  RESULTS
  In a 3-month window, if only well-child care visits were used for first immunization, 97% of 5- and 6-year-olds and 98% of 7- and 8-year-olds would need 1 or 2 additional visits for complete vaccination; 95% of 9- to 18-year-olds would need 1 visit. If instead all visits were used for immunization, 90% of 5- and 6-year-olds and 91% of 7- and 8-year-olds would need 1 or 2 visits; 78% of 9- to 18-year-olds would need 1 visit. Expanding the window to 4 or 5 months slightly reduces the need for additional visits. Nationally, using all opportunities for vaccination, 42 million additional visits would be needed in a generous 5-month window.
  
  
  CONCLUSIONS
  Most children and adolescents would need additional visits for universal influenza vaccination, even if all existing visits were used as vaccination opportunities. Efficient methods for vaccinating large numbers of children and adolescents are needed if primary care practices are to provide influenza vaccine for all children.
authors.affiliation: Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, USA. cynthia_rand@urmc.rochester.edu
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Rand
authors.forename: Peter G
authors.initials: PG
authors.lastname: Szilagyi
authors.forename: Byung-Kwang
authors.initials: BK
authors.lastname: Yoo
authors.forename: Peggy
authors.initials: P
authors.lastname: Auinger
authors.forename: Christina
authors.initials: C
authors.lastname: Albertin
authors.forename: Margaret S
authors.initials: MS
authors.lastname: Coleman
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003710:Demography; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data*