Iwane Marika K, Singleton James A, Walton Kimp, Coulen Charmaine, Wooten Karen
Centers for Disease Control and Prevention/National Center for Immunization and Respiratory Disease (CDC/NCIRD), Atlanta, Georgia 30333, USA.
J Public Health Manag Pract. 2007 May-Jun;13(3):307-13. doi: 10.1097/01.PHH.0000267689.61647.f4.
Influenza vaccination among US adults has plateaued at suboptimal levels. Severe delays and shortages of influenza vaccine prompted revised guidances to prioritize vaccine first to persons at greatest risk for serious influenza complications and to create vaccine stockpiles.
(1) Pilot an assessment of influenza vaccine use in a large sample of physician offices with adult patients. (2) Apply the method to assess vaccine receipt by age and risk groups.
Influenza vaccination and risk status for the 2000-2001 season were obtained from record review conducted in November 2001 to April 2002 for adult patients in a sample of physicians' offices in eight states. Participating physicians also completed a questionnaire.
The assessment method was feasible to implement. One hundred eighteen physicians participated. They administered more than 83 percent of doses to prioritized groups in October and November compared with 74 percent of doses during the entire season. Office-based vaccination coverage was less than 40 percent in all age and risk groups. More than 50 percent of participating physicians reported unused doses.
Office-based assessments of vaccine utilization can be a valuable evaluation tool. Vaccine distribution was consistent with recommendations to target early vaccination to priority groups. Results highlight the difficulty distributing vaccine late in the season and the need for strategies to improve vaccination coverage, particularly when vaccine supply is inadequate.
美国成年人的流感疫苗接种率一直停留在不理想的水平。流感疫苗的严重延误和短缺促使指南修订，将疫苗优先提供给患严重流感并发症风险最高的人群，并建立疫苗储备。
（1）在大量有成年患者的医生办公室中试点评估流感疫苗的使用情况。（2）应用该方法按年龄和风险组评估疫苗接种情况。
通过对2001年11月至2002年4月在八个州的一组医生办公室中的成年患者进行记录审查，获取2000 - 2001年流感季节的疫苗接种情况和风险状态。参与的医生还填写了一份问卷。
该评估方法实施可行。118名医生参与其中。与整个季节74%的接种剂量相比，他们在10月和11月将超过83%的剂量接种给了优先群体。所有年龄和风险组基于办公室的疫苗接种覆盖率均低于40%。超过50%的参与医生报告有未使用的剂量。
基于办公室的疫苗使用评估可以成为一种有价值的评估工具。疫苗分发符合针对优先群体进行早期接种的建议。结果凸显了在流感季节后期分发疫苗的困难以及需要采取策略提高疫苗接种覆盖率，特别是在疫苗供应不足时。
