182 - Improving Pediatric Inpatient Influenza Vaccination Rates during the COVID-19 Pandemic

Poster Number: 182
Publication Number: 182.142

Rouba Sayegh, Nationwide Children's Hospital, Columbus, OH, United States; Ana M. Quintero, Nationwide Children's Hospital, Columbus, OH, United States; Juan D. Chaparro, Nationwide Children's Hospital, Columbus, OH, United States; Matthew C. Washam, Nationwide Children's Hospital, Columbus, OH, United States; Don A. Buckingham, Nationwide Children's Hospital, Columbus, OH, United States; Donnie Clark, Nationwide Children's Hospital, Columbus, OH, United States; William J. Barson, The Ohio State College of Medicine, Columbus, OH, United States; Guliz Erdem, Nationwide Children's Hospital, Columbus, OH, United States

Background: The COVID-19 pandemic caused significant disruptions in routine childhood immunizations. Initial pandemic restrictions that decreased respiratory infections lessened the perceived need for influenza vaccinations. In 2021, increased rates of both COVID-19 and influenza infection coupled with loosened restrictions created further urgency to improve influenza vaccination rates. Inpatient vaccination efforts became more important to catch up on the missed vaccinations.

Objective: To assess pre-pandemic and pandemic influenza vaccination rates in a busy inpatient unit while leveraging new improvement efforts.

Design/Methods: We calculated the rates of vaccination among children admitted to the Infectious Disease inpatient unit at Nationwide Children’s Hospital between September 2019 and December 2021 using Qlik SenseR data platform. We defined our population as the age-eligible patients who did not have a contraindication. We then assessed the number of eligible patients who had documentation of vaccination before admission and patients who received their vaccine during their hospitalization. In 2021, we implemented new measures to improve vaccination rates. In addition to EMR best practice alerts (BPA), we re-educated medical staff, sent SMS messages reminders to inpatient families to complete the vaccinations. We provided vaccination hand-outs upon admission, created incentives for house staff to alert families while rounding and displayed messages throughout the hospital displays to promote vaccination efforts.

Results: Rates of vaccination in eligible children were 52% and 44% in 2019 and 2020 respectively. However, the rates of patients who received inpatient vaccination only were significantly lower at 24.7% (288 out of 1168 patients) and 13.5% (135 out of 998 patients) in 2019 and 2020 respectively (P < 0.0001) (Table 1). During 2020, more BPAs were unanswered. Staff shortages affected the opportunities to discuss the vaccinations. 10.6% of white children and 16% of non-white children were vaccinated. Rates of vaccination by the end of December 2021 were already higher than those at the end of the previous season (14.8% vs 13.5%) suggesting the success of our newly implemented QI measures.Conclusion(s): Our inpatient influenza vaccination rates significantly declined during the COVID-19 pandemic suggesting missed opportunities. The current improvement shows that promoting inpatient influenza vaccination is increasingly more important during the pandemic.
Figure 1: Key Driver Diagram: Improvement of Inpatient Influenza Vaccination
Table 1: Inpatient Influenza Vaccination rates during the last 3 seasons