Missed Opportunities for Influenza Vaccination and Its Serious Consequences

¹Department of Preventive Medicine, Quality and Patient Safety, Specialized Care Management Areas III and IV, Sierrallana Hospital, Torrelavega, Cantabria, Spain

²Department of Infection Control and Epidemiology, Obispo Polanco Hospital, Teruel, Spain

*Corresponding Author:

Juan Rodríguez-García
Preventive Medicine
Quality and Patient Safety
Specialized Care Management Areas
III and IV, Sierrallana Hospital
Torrelavega, Cantabria, Spain
Tel: +34 696 680 681
E-mail: juan.rodriguez@scsalud.es

Received date: January 19, 2015; Accepted date: February 17, 2015; Published date: February 20, 2015

Citation: Rodríguez-García J (2015) Missed Opportunities for Influenza Vaccination and Its Serious Consequences Rodríguez-García, et al., J Community Med Health Educ 5:335. doi: 10.4172/2161-0711.1000335

Copyright: © 2015 Rodriquez-Gracia J, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

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Abstract

During the flu season, epidemics of this disease result in a significantly higher hospitalization and death rates. Annual vaccination is the most effective strategy for preventing influenza infection and its complications. Although it is recommended that previously unvaccinated hospitalized patients, are offered the opportunity – and, indeed, encouraged – to be vaccinated before discharge, studies show that these opportunities are often missed

Letter to Editor

During the flu season, epidemics of this disease result in a significantly higher hospitalization and death rates. Annual vaccination is the most effective strategy for preventing influenza infection and its complications. Although it is recommended that previously unvaccinated hospitalized patients, are offered the opportunity – and, indeed, encouraged – to be vaccinated before discharge, studies show that these opportunities are often missed [1,2].

To ascertain the characteristics of these missed opportunities, a descriptive study was conducted including all confirmed, severe, hospitalized cases during the 2013/14 flu season. Using the national Public Health definition, severe case was considered as: hospitalized patient with polymerase chain reaction positive test for Influenza, and pneumonia, respiratory distress syndrome, multiple organ failure, septic shock or intensive care unit admission. Information about visits of these patients to the health care centres was collected retrospectively. All visits from the date that vaccination was available up to two weeks before the onset of flu-like symptoms were recorded.

Twenty-one patients were included. The mean patient age was 59.4 years; 95% confidence interval (CI 95%): 51.5-67.2 years. Ten patients (47.6%) were male. Mean hospitalization was 14.8 days; CI 95%: 2.8-26.8 days; five cases were subtype An/H1N1 (23.8%); two (9.5%) were A/H3N2; and fourteen (66.7%) were A, not subtyped. Five patients (23.8%) died during hospitalization; sixteen (76.2%) met vaccination criteria but only five (31.3%) of them had been previously vaccinated in the flu season. Four (36.4%) of the eleven previously unvaccinated patients that met the vaccination criteria had visited health centres on a total of six occasions for non-flu related causes during the period studied: two patients did it twice and the other two in one occasion. These visits were: one to primary care centre, three to the emergency department and two were hospital admissions.

Several factors have been associated with missed opportunities for Influenza vaccination in patients at risk of complications. These include patients’ unawareness that they could be vaccinated during hospitalization [3], or that they belonged to a risk group [4,5]. One of the most important factors associated with patients’ intention to be vaccinated is a doctor’s recommendation [3]. Thus, it is our belief that if the patient's condition permits this, doctors should recommend vaccine against Influenza virus to those patients for whom it is indicated, at any healthcare visit or hospitalization period during the flu season [2,3]. Failure to do so means missing an important opportunity to prevent serious flu complications, including death.

References

1. Fiore AE, Shay DK, Broder K, Iskander JK, Uyeki TM, et al. (2009) Centers for Disease Control and Prevention. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep 58(RR-8): 1-52.
2. Bratzler DW, Houck PM, Jiang H, Nsa W, Shook C, et al. (2002) Failure to vaccinate Medicare inpatients: a missed opportunity. Arch Intern Med 162: 2349-56.
3. Hernández-García I (2011) Acceptability of A/H1N1 vaccination among hospitalized patients. Med Clin (Barc)136: 694-695.
4. Brewer NT, Hallman WK (2006) Subjective and objective risk as predictors of influenza vaccination during the vaccine shortage of 2004-2005. Clin Infect Dis 43: 1379-1386.
5. Urun Y, Akbulut H, Demirkazik A, Cay Senler F, Utkan G, et al. (2013) Perception about influenza and pneumococcal vaccines and vaccination coverage among patients with malignancies and their family members. J BUON 18: 511-515.