Chin Justin, Zhou YaQun, Chen Chijen L, Lomiguen Christine M, McClelland Suzanne, Lee-Wong Mary
Medicine, Lake Erie College of Osteopathic Medicine, Erie, USA.
Family Medicine, LifeLong Medical Care, Richmond, USA.
Cureus. 2021 Jan 7;13(1):e12549. doi: 10.7759/cureus.12549.
Many comparisons have been made on the effect and impact of COVID-19 on influenza pandemics of history. Therefore, it is reasonable to infer that the strategies utilized by healthcare providers to improve influenza vaccination rates can similarly be applied to the administration of a COVID-19 vaccine. The purpose of this study was to determine the rationale of low influenza vaccination rates in an urban allergy clinic and how to improve patient education and knowledge regarding the importance of influenza vaccination. A three-year comparison of interventions is presented as well as its application to future COVID-19 vaccinations.
This study was performed at an outpatient allergy and clinical immunology practice (MSBI) with hospital affiliation in New York City, New York. A quality improvement medical committee was formed to optimize influenza vaccination rates to greater than 71% and established standardized protocols regarding patient intake workflows, vaccine counseling, and documentation. Patient records from four providers were used for this study to compare pre-and post-intervention rates.
984 patients met inclusion criteria, with a normal distribution of ages (18-80), race, and sex. Average vaccination rates prior to the intervention were 9.25-13.60%. The average vaccination rate after the intervention was 91.34%.
The MSBI quality improvement study identified key areas to address in improving influenza vaccination rates. Vaccine hesitancy, public misinformation, and ambivalence surrounding vaccination with egg allergies or during a subcutaneous immunotherapy injection were all topics addressed during the 2018-2019 intervention year. Additional attention was also put toward provider education and standardization of documentation. Shared decision making and intensive education/outreach efforts are needed by physicians and patients alike to overcome vaccine hesitancy. In comparing this to upcoming COVID-19 vaccine challenges, similar barriers will likely also need to be addressed. Greater research is needed to understand patient motivations regarding hesitancy specific to the COVID-19 vaccine.
As evidenced in the yearly battle with influenza and now the COVID-19 pandemic, it has become essential to identify and implement multi-level strategies to maximize vaccination rates, especially amid a global pandemic. With COVID-19 vaccines reaching emergency approval stages, it is important for healthcare providers to start creating workflows and strategies to address patient inquiries. The influenza vaccination quality improvement project presented here can be used as a guideline for future evaluations of COVID-19 vaccination efforts.
人们已对新冠病毒病（COVID-19）对历史上流感大流行的影响和冲击进行了诸多比较。因此，有理由推断，医疗服务提供者提高流感疫苗接种率所采用的策略同样可应用于新冠疫苗的接种。本研究的目的是确定一家城市过敏诊所流感疫苗接种率低的原因，以及如何加强患者教育，让其了解流感疫苗接种的重要性。本文呈现了为期三年的干预措施比较情况，以及其在未来新冠疫苗接种中的应用。
本研究在纽约市一家隶属于医院的门诊过敏与临床免疫诊所（MSBI）开展。成立了一个质量改进医疗委员会，将流感疫苗接种率优化至71%以上，并制定了关于患者接待流程、疫苗咨询和记录的标准化方案。本研究使用了四位医生的患者记录，以比较干预前后的接种率。
984名患者符合纳入标准，年龄（18 - 80岁）、种族和性别呈正态分布。干预前的平均接种率为9.25% - 13.60%。干预后的平均接种率为91.34%。
MSBI质量改进研究确定了提高流感疫苗接种率需要解决的关键领域。疫苗犹豫、公众错误信息以及围绕鸡蛋过敏或皮下免疫治疗注射期间接种疫苗的矛盾情绪，都是2018 - 2019年干预年度所涉及的话题。还额外关注了医生教育和记录标准化。医生和患者都需要通过共同决策以及强化教育/推广努力来克服疫苗犹豫。将此与即将到来的新冠疫苗接种挑战相比较，可能也需要应对类似的障碍。需要开展更多研究，以了解患者对新冠疫苗犹豫的动机。
正如每年与流感的斗争以及现在与新冠疫情的斗争所证明的那样，识别并实施多层次策略以最大化疫苗接种率至关重要，尤其是在全球大流行期间。随着新冠疫苗进入紧急批准阶段，医疗服务提供者开始创建工作流程和策略来应对患者咨询非常重要。本文介绍 的流感疫苗接种质量改进项目可作为未来新冠疫苗接种工作评估的指南。
