Impact of a Severe Influenza Vaccine Shortage on Primary Care Practice

Department of Pediatrics, University of Colorado at Denver Children's Hospital, Denver, USA.
American Journal of Preventive Medicine (Impact Factor: 4.53). 01/2008; 33(6):486-91. DOI: 10.1016/j.amepre.2007.07.038
Source: PubMed


Because of influenza vaccine shortages during the 2004-2005 influenza season, vaccine was targeted for high-risk priority groups.
To assess among primary care physicians: (1) ability to identify priority patients; (2) extent of shortages; and (3) effects of shortages on vaccine redistribution, patient referral and future plans for vaccine delivery.
Mailed surveys of pediatric (Peds), family medicine (FM), and general internal medicine (GIM) physicians randomly selected from the American Medical Association master file.
Response rate was 37% and the study population included 377 Peds, 319 FM, and 251 GIM physicians. Seventy-five percent of Peds, 58% of FM and 60% of GIM had some method to identify priority patients, although only 39%, 21%, and 18%, respectively, had a computerized method. Forty-five percent of Peds, 73% of FM, and 75% of GIM experienced shortages, for a median of 2-3 months. Approximately 48%-50% of Peds, FM, and GIM obtained additional influenza doses; among these, 53% received vaccine from a public health entity. Fifty-one percent of Peds, 79% of FM, and 80% of GIM referred high-risk patients for immunization, 94% of the time to a public health clinic. More than 95% planned to administer influenza vaccine next season.
The majority of physicians experienced influenza vaccine shortages for prioritized patients, especially those providers caring for adults. There was significant vaccine redistribution and patient referral, primarily involving the public health system. Enhancing methods of targeting priority patients and increasing cooperation with public health entities should be priorities in dealing with future influenza vaccine shortages.

1 Follower
8 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Adaptive array weight adjustment algorithms are described by time varying stochastic differential equations. A new method employing a two-variable perturbation analysis is used to investigate the effects of the weight fluctuations on the Applebaum algorithm performance in the presence of multiple jammers. An explicit solution of the directivity pattern in the direction of the jammers for the two-jammer problem is derived. An improved formula for the output signal-to-interference plus noise ratio (SINR) is obtained. It is shown as expected that the greater the number of signals at the array input the greater the degradation in the directivity pattern in the direction of the interfering signals and the greater the degradation in the output SINR. In addition, we show that the performance degrades uncontrollably when the number of independent jammers approaches the number of array elements. A comparison is made of the new results and those obtained using standard approximations. Substantial differences are caused by first-order terms in the perturbation.
    No preview · Conference Paper · Nov 1985
  • [Show abstract] [Hide abstract]
    ABSTRACT: The Ad hoc Networking Over UTRA-TDD Protocol (Barnawi and Gardiner (2003)) (ANOUP) was introduced by our research group as a protocol to combine ad hoc networking with the fixed wireless infrastructure. The aim of that combination is to improve the capacity and coverage of the cellular system. In this paper we evaluate the impact of ANOUP on the system's performance. It is shown that at a fairly good link capacity, coverage improvement of 100 % is quite achievable.
    No preview · Conference Paper · Jun 2004

  • No preview · Article · Sep 2008 · Journal of the American Pharmacists Association
Show more