Patients with cardiovascular disease are at the greatest risk for influenza-related mortality, yet flu vaccination rates among this population fall far below national vaccination targets. But a new
By simply making flu vaccine available in all cardiology offices and encouraging cardiologists to recommend vaccination for their patients, the study found immunization rates among non-elderly adults with cardiac disease could dramatically improve and approach the Healthy People 2010 goal of 60 percent vaccination coverage for the population at the highest risk for flu.
The results from this study currently appear on the Human Vaccines Web site, and results will appear in the journal later this month.
With approximately 12.5 million people, cardiac disease patients are the largest high-risk group of non-elderly adults in the
The answer to improving vaccination rates among this group is to make flu vaccine available in all cardiology offices and have cardiologists strongly recommend it, says
For this study,
The interventions studied included improvements in vaccine availability in cardiology practices, physician recommendation rates, performance of primary care and medical subspecialty practices, inpatient vaccination rates, patient acceptance, and community vaccination programs.
Assuming, under normal circumstances, that there was a sufficient supply of the flu vaccine available in a wide variety of settings, the overall vaccination coverage for this high-risk population was 36.3 percent, of which 65 percent of individuals were immunized within the healthcare system and 35 percent were immunized at community sites.
But when flu vaccine was available in all cardiology practices, the vaccine coverage for cardiac patients jumped to 41 percent. Similarly, when cardiologists strongly recommended flu vaccination to their patients, vaccine coverage grew to 37.4 percent.
What yielded the greatest results in cardiology practices was combining the two efforts, in conjunction with routine orders for nurses to vaccinate unless the patient had opted out. That effort, the study revealed, would lead to overall vaccine coverage of 45.7 percent, or about a 25 percent relative increase in the vaccination rate for non-elderly patients with cardiac disease.
If such interventions in cardiology practices were combined with additional efforts to maximize vaccination at other doctors offices, hospitals and in the community, the vaccination rate would likely reach 62.3 percent, exceeding the 60 percent vaccination coverage target set by Healthy People 2010, a set of health objectives for the nation to achieve over the first decade of the new century.
Even if a vaccination shortage were to occur, these combined interventions would still allow for a larger portion of non-elderly adult cardiac patients to be vaccinated again flu compared to current circumstances,
Our model suggests that optimizing influenza vaccine delivery in cardiology practices would improve overall vaccination rates for this population, especially during flu vaccine shortages, explains
Reference: Human Vaccine, Vol. 1, No. 6.
Source: University of Michigan Health System