A systematic literature review identified 44 RCTs testing interventions to increase influenza vaccination rates among seniors >or=60. Case-control and cohort studies were excluded after review because of problems identifying secular trends and unknown confounders. Because of heterogeneity and unique interventions tested by a single or a few RCTs few studies could be pooled in meta-analysis. Using the CDC classification of interventions: (1) Increasing community demand: there is evidence of low quality that reminders increase influenza vaccination rates; (2) Increasing access: there is evidence of moderate quality that home visits to those >or=60 promoting influenza vaccination increase rates, and (3) Provider- and system-based interventions: there is evidence of moderate quality that facilitators working to improve preventive interventions in practices increase rates.
"Removal of logistic barriers could give the elderly an incentive to accept vaccination and obtain it at locations other than the GP's office . There is strong evidence that vaccinating elderly people during home visits and using facilitators in the practice, for instance, would increase uptake of the influenza vaccine (Thomas et al., 2010). The effect of such interventions remains to be demonstrated among community-dwelling adults, however (Lau et al., 2012). "
[Show abstract][Hide abstract] ABSTRACT: In a population of seniors served by urban primary care centers, we evaluated the effect of the practice-based intervention on influenza immunization rates and disparities in vaccination rates by race/ethnicity and insurance status.
A randomized controlled trial during 2003-2004 tested patient tracking/recall/outreach and provider prompts on improving influenza immunization rates. Patients aged > or = 65 years in six large inner-city primary care practices were randomly allocated to study or control group. Influenza immunization coverage was measured prior to enrollment and on the end date.
At study end, immunization rates were greater for the intervention group than for the control group (64% vs. 22%, p < 0.0001). When controlling for other factors, the intervention group was more than six times as likely to receive influenza vaccine. The intervention was effective across gender, race/ ethnicity, age, and insurance subgroups. Among the intervention group, 3.5% of African Americans and 3.2% of white people refused influenza immunization.
Patient tracking/recall/outreach and provider prompts were intensive but successful approaches to increasing seasonal influenza immunization rates among this group of inner-city seniors.
Public Health Reports 01/2011; 126 Suppl 2:39-47. DOI:10.2307/41639284 · 1.55 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective
Immunized status has ceased to be a childhood phenomenon and is now applicable throughout life. Reports show that, in people aged > 64 years raising vaccination coverages against vaccine-preventable diseases may be important. The objective of this study was to determine knowledge of and attitudes to vaccines and vaccination (especially the influenza, pneumococcal and tetanus vaccines) in this population group in order to increase their level of acceptance.
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