Seasonal Influenza Vaccination Reminders for Children with High-Risk Conditions A Registry-Based Randomized Trial
Seasonal Influenza Vaccination Reminders for Children with High-Risk Conditions A Registry-Based Randomized Trial
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DOI：
10.1016/j.amepre.2011.09.028
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发表时间：
2012-01-01
影响因子：
5.5
通讯作者：
Clark, Sarah J.
中科院分区：
文献类型：
--
作者：
Dombkowski, Kevin J.;Harrington, Laura B.;Clark, Sarah J.
背景资料：慢性病儿童患流感并发症的风险增加，且流感疫苗接种率低。目的：评估使用全州免疫信息系统（IIS）的可行性和有效性，该系统用于地方卫生部门（LHD）针对高危儿童的季节性流感疫苗提醒。设计：随机社区干预。设置/参与者：该研究针对居住在密歇根州三个县的3618名年龄在24-60个月之间、患有高风险疾病的儿童进行。2008年10月，使用全州范围的IIS确定了儿童。干预：儿童被随机分为干预组（提醒）或对照组（无提醒）。2008年11月由LHD邮寄季节性流感疫苗接种提醒。主要结局指标：评估通知的可行性（地址有效性、地址可传递性）（2008年11月至2009年2月），确定通知可行性措施的频率（2010年进行分析）。通知（季节性流感疫苗接收）的有效性进行了评估，采用双变量logistic regression.Results：在3618名儿童的高风险条件，2730（75.5%）没有收到20082009年流感疫苗接种，并在通知时合格。在被分配到提醒组的儿童（n = 1374）中，42.6%的地址被确定为无效、无法投递或两者兼而有之。在那些有有效地址的人中（n = 2001），有可交付提醒的儿童中，至少接种了一次流感疫苗的比例更高（30.8%）在结果观察期间，（24.3%，OR = 1.39，95% CI = 1.13，1.72）;无法投递提醒的儿童流感疫苗接种率结论：收到提醒与季节性流感疫苗接种呈正相关。然而，超过40%的被分配接收提醒的儿童被确定为无效或无法送达的地址，强调需要提高IIS联系信息的质量。
Background: Children with chronic conditions have an increased risk of complications from influenza and have low influenza vaccination rates.Purpose: To assess the feasibility and effectiveness of using a statewide immunization information system (IIS) for seasonal influenza vaccine reminders from local health departments (LHDs) targeting children with high-risk conditions.Design: A randomized community intervention.Setting/participants: The study was conducted in a population of 3618 children aged 24-60 months with a high-risk condition residing in three Michigan counties. Children were identified using a statewide IIS in October 2008.Intervention: Children were randomized to intervention (reminder) or control (no reminder) groups. Reminders for seasonal influenza vaccination were mailed by LHDs in November 2008.Main outcome measures: Feasibility of notification (address validity, address deliverability) was assessed (November 2008-February 2009), and frequencies of notification feasibility measures were determined (analyses conducted in 2010). Effectiveness of notification (seasonal influenza vaccine receipt) was assessed using bivariate logistic regression.Results: Among 3618 children with a high-risk condition, 2730 (75.5%) had not received a 20082009 influenza vaccination and were eligible at the time of notification. Among children assigned to the reminder group (n = 1374), 42.6% had an address determined to be either invalid, undeliverable, or both. Among those with valid addresses (n = 2001), a greater percentage of children with deliverable reminders received at least one influenza vaccination (30.8%) during the outcome observation period than did children assigned to no reminder (24.3%, OR = 1.39, 95% CI = 1.13, 1.72); children with an undeliverable reminder had an influenza vaccination rate (22.8%) similar to children assigned to no reminder.Conclusions: Receipt of a reminder was positively associated with seasonal influenza vaccination. However, more than 40% of children assigned to receive a reminder were determined to have an invalid or undeliverable address, emphasizing the need for increased quality of IIS contact information.