An opt-out influenza vaccination policy improves immunization rates in primary care

J Health Care Poor Underserved. 2011 Feb;22(1):232-42. doi: 10.1353/hpu.2011.0009.

Abstract

Purpose/objective: During the 2007-08 influenza season 36% of outpatients seen at our urban family medicine center received an influenza immunization. We explored the expected increase in vaccinations from an opt-out policy using standing orders in a lower-income population.

Methods: A comparison of vaccination rates during the periods 10/1/2007 to 3/31/2008 (P1) versus 10/1/2008 to 3/31/2009 (P2) with adjustments for cohort non-independence.

Results: The overall P2 vaccination rate increased to 49% [p<.000001]. P2 rates were significantly higher for those with diabetes, both genders, African American and European American patients from 3 to 64 years old, and in all insurance groups. The vaccination rates for patients with Medicaid insurance (37% and 54%) were higher than the rates for patients with commercial insurance (31% and 43%).

Conclusions: The opt-out policy is associated with a moderate (1.4 fold) increase in the vaccination rate. Primary care resource constraints may limit further improvement.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • African Americans / statistics & numerical data
  • Aged
  • Child
  • Child, Preschool
  • Diabetes Mellitus
  • Family Practice
  • Female
  • Health Policy*
  • Humans
  • Immunization / statistics & numerical data*
  • Immunization / trends*
  • Infant
  • Influenza Vaccines / administration & dosage*
  • Insurance, Health / statistics & numerical data
  • Male
  • Medicaid / statistics & numerical data
  • Middle Aged
  • Poverty
  • Primary Health Care / statistics & numerical data*
  • United States
  • Urban Health Services
  • Whites / statistics & numerical data
  • Young Adult

Substances

  • Influenza Vaccines