And other concise reviews of studies on immunizations
December 2015, Vol 3, No 12 - Inside Immunization

In This Article




Influenza Vaccination of Primary Care Providers Linked to Patients’ Vaccination Status

Influenza is associated with significant disease burden, is highly contagious, and is estimated to affect 5% to 15% of the world’s population annually. Previous studies have established a link between the vaccination status of physicians and the effectiveness of their vaccine recommendations to their patients.

To assess the impact of physician-related factors on the vaccine status of their patients (≥65 years), Pere Godoy, from the Agencia de Salud Pública de Cataluña, Barcelona, Spain, and colleagues conducted an epidemiologic study comparing the incidence of influenza vaccine coverage in patients aged ≥65 years with that of primary care physicians.

The vaccination coverage data were obtained from regional records. Anonymous, online, 23-question surveys were directed toward 2535 primary care physicians working in 253 primary care centers that were randomly selected from 7 Spanish regions between March 1 and May 25, 2012.

Of the 815 physicians who responded to the survey and who were included in the analysis, 55.3% were vaccinated against the flu. Factors associated with higher vaccination rates included physicians who believed that influenza was a severe illness. Overall, 56.3% of patients aged ≥65 years were vaccinated. The authors observed that the influenza vaccination rates were higher among patients whose physicians were vaccinated (57.3%), compared with patients whose physicians were not vaccinated (55.2%).

“Vaccination of physicians together with their opinions on the effectiveness of the vaccine may be a predictor of vaccination coverage in their patients,” the study authors concluded.

  1. Godoy P, Castilla J, Mayoral JM, et al. Influenza vaccination of primary healthcare physicians may be associated with vaccination in their patients: a vaccination coverage study. BMC Fam Pract. 2015;16:44.

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EHR Alerts Significantly Increase Uptake, Completion of HPV Vaccine Series

Initiating and completing the human papillomavirus (HPV) vaccination of young adults in a timely fashion is crucial. The Advisory Committee on Immunization Practices (ACIP) recommends routinely vaccinating girls and boys aged 11 or 12 years with 3 separate 0.5-mL doses of an HPV vaccine.

As part of a retrospective cohort study, Mack T. Ruffin IV, MD, MPH, Department of Family Medicine, University of Michigan, Ann Arbor, and colleagues examined the effect of electronic health record (EHR) alerts on HPV vaccine initiation, series completion, and adherence to ACIP-recommended dosing intervals on eligible women.

The investigators included 2 groups of girls and women aged 9 to 26 years who had ≥1 appointments with their physician between March 1, 2007, and January 25, 2010, at 2 different family practices. One group was given a reminder (prompted cohort; n = 5994), whereas the other was not (unprompted cohort; n = 9027).

Overall, a significantly higher number of patients initiated the HPV vaccine in the prompted (35.0%) versus unprompted cohort (21.3%); completion of the vaccine series in a timely fashion was also higher in the prompted cohort compared with the unprompted cohort. The researchers also noted that African American patients who were in the prompted cohort were considerably more likely to initiate the vaccine than white patients, and patients who had ≥3 visits during the study period were associated with increased initiation in both cohorts.

  1. Ruffin MT IV, Plegue MA, Rockwell PG, et al. Impact of an electronic health record (EHR) reminder on human papillomavirus (HPV) vaccine initiation and timely completion. J Am Board Fam Med. 2015;28:324-333.

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Routine Quadrivalent Influenza Vaccination May Reduce Influenza Infections

Regulating seasonal epidemics of influenza is challenging for healthcare professionals, and although vaccinations have demonstrated efficacy, the antigenic composition of vaccines frequently does not match the virus strains that are circulating.

To examine the impact of a quadrivalent influenza vaccine on people in the United States, Pascal Crépey, EHESP Rennes, Sorbonne Paris-cité, Paris, France, and colleagues performed a retrospective analysis comparing what the potential benefit of a quadrivalent versus trivalent influenza vaccine would have been on public health between 2000 and 2013. Using data from the Centers for Disease Control and Prevention weekly influenza activity reports, the authors developed a dynamic, compartmental model that accounts for interactions between influenza B lineages that are natural or vaccine-induced, and simulates the multiyear influenza dynamics for 2000 through 2013.

Results indicated that the quadrivalent influenza vaccination would have prevented 16% more B lineage influenza cases than the trivalent influenza vaccination. Patients aged 50 to 64 years and ≥65 years benefit most from the quadrivalent influenza vaccine, which reduced B lineage cases in this patient population by 18% and 21%, respectively. Crépey and colleagues noted that by reducing the cross-protection of the vaccine efficacy to 50%, 30%, and 0% of the matched vaccine, the relative benefit of quadrivalent influenza vaccines improves to 25%, 30%, and 34% fewer B lineage cases for all age-groups.

  1. Crépey P, de Boer PT, Postma MJ, Pitman R. Retrospective public health impact of a quadrivalent influenza vaccine in the United States. Influenza Other Respir Viruses. 2015;9 (Suppl 1):39-46.

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