Dua K. Siam, MSN, APRN, FNP-cUniversity of Alabama

Capstone College of NursingTuscaloosa, Alabama

Influenza Vaccine and Children: Evaluation of Vaccine Compliance and Subsequent Influenza-like Illness at a Pediatric Primary Care Clinic

The purpose of the study is to investigate the relationship between influenza vaccination adherence and the rate of subsequent influenza-like illness among children age 6month to 18 years of age.

PURPOSE OF THE STUDY

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The World Health Organization (WHO) attributes up to five million severe illness and up to one half million deaths each year to influenza

The Centers for Disease Control and Prevention (CDC) has issued recommendation that all children age 6 months to 18 years of age be vaccinated

Significance

In spite of the best efforts by the CDC and the healthcare providers , the rate of immunization to prevent influenza does not seem to be affected.

Influenza among children is associated with increased medical costs directly through the care of sick children and indirectly through increased work absenteeism among adults caring for infected children

Significance

• Caregivers disinterest in vaccinating their children

• Perceptions of risk of contracting influenza from the vaccine

• Misconceptions about the efficacy of the vaccine

• Exposure to media outlets that spread rumors about adverse effects of immunizations or the ineffectiveness of the vaccine

LITERATURE REVIEW

Setting:

• The study is a retrospective chart review• Rural southeast Kansas pediatric primary care clinic• Investigated:

1. Relationship between influenza vaccination adherence and the rate of subsequent influenza-like illness among children

2. Rate of Practitioner offered influenza vaccine3. Rate of patient/family acceptance of vaccination

METHODOLOGY

SAMPLE:

• Patients 6 months to 18 years of age• Clinic visits starting September 1, 2013 and ending February 28, 2014• Inclusion criteria: age 6 months to 18 years at the index visit between the specified dates• Exclusion criteria: all patients less than 6 months of age were excluded • Power analysis for Chi square goodness of fit test with parameters set at 0.05 alpha and 0.80

power yielded a sample size of 143 charts to be reviewed.

METHODOLOGY

PROCEDURE

• Human subjects approval was obtained from the Internal Review Board at the University of Alabama, Tuscaloosa

• Query of the system created a list of charts meeting inclusion criteria• List developed using a random number approach• The random number was generated to replace the patient name on the identified charts

with a study ID number• Variables assessed are listed in the data collection tool included: age, visit date, reason for

visit, caregiver presence, type of provider, vaccine offered, vaccine accepted, return sick visit, diagnosis for return visit.

• Charts were selected using the random number approach according to the de-identified study ID numbers

• Total of 143 charts were selected• Charts which were duplicates were replaced by more charts being selected using the same

random method of selection to bring the total number of charts to 143 unique charts

METHODOLOGY

ANALYSIS

• The grouping variable is patients who have received the vaccine versus those who have not.• Within the grouping variable three groups exist: vaccinated, offered and declined, not

offered• The dependent variable: illness versus no illness• This allowed the examination of the relationships between those who received the vaccine

and did or did not become ill, versus those who did not receive the vaccine and did or did not become ill

COLLECTION TOOL

ANALYSIS

The data was collected and tabulated. Sample size : 143 charts, broken into three age categories:

• 6 months to 35 months age categories total of 44 charts reviewed

• 36 months to 8 years and 11 months a total of 52 charts

• 9 years to 18 years total of 47 charts

FINDINGS

FINDINGS

FINDINGS

FINDINGS

FINDINGS

FINDINGS

IMPLICATION

Whenever the vaccine is offered, the rate of acceptance of the vaccine exceeds 79%.

it is worth noting from this study that the provider plays a very important role in promoting the influenza vaccine and the influence that exerts on the parents and caregivers in acceptance of the vaccine

RECOMMENDATIONS

It is recommended that the healthcare provider make a more conscious effort at offering the vaccine to the patient since the data show that when the vaccine is offered, the rate of acceptance exceeds 79%