Declining influenza vaccination rates in an underserved pediatric primary care center during the COVID-19 pandemic.

BACKGROUND: Influenza vaccination rates are decreasing in the United States. Disinformation surrounding COVID-related public health protections and SARS-CoV-2 vaccine roll-out may have unintended consequences impacting pediatric influenza vaccination.We assessed influenza vaccination rates before and during the COVID-19 pandemic in one pediatric primary care center, serving a minoritized population. METHODS: A cross-sectional study assessed influenza vaccination rates for children aged 6 months to 12 years over the following influenza seasons (September-May): 1) 2018-19 and 2019-20 (pre-pandemic), and 2) 2020-21 and 2021-22 (intra-pandemic). Demographics and responses to social risk questionnaires were extracted from electronic health records. Total tetanus vaccinations across influenza seasons served as approximations of general vaccination rates. Generalized linear regression models with robust standard errors evaluated differences in demographics, social risks, and influenza vaccination rates by season. Multivariable logistic regression with robust standard errors evaluated associations between influenza season, demographics, social risks, and influenza vaccination. RESULTS: Most patients were young (mean age âˆ¼ 6 years), non-Hispanic Black (∼80%), and publicly insured (∼90%). Forty-two percent of patients eligible to receive the influenza vaccine who were seen in 2019-20 influenza season received the influenza vaccine, compared to 30% in 2021-22. Influenza and tetanus vaccination rates decreased during the COVID-19 pandemic (p < 0.01). The 2020-21 and 2021-22 influenza seasons, older age, Black race, and self-pay were associated with decreased influenza vaccine administration (p < 0.05). CONCLUSIONS: Influenza vaccination rates within one pediatric primary care center decreased during the COVID-19 pandemic and have not rebounded, particularly for older children, those identifying as Black, and those without insurance.

Increasing HPV Vaccination Coverage Through Provider-Based Interventions.

With discouragingly low vaccination rates for human papillomavirus (HPV), we sought to improve the HPV vaccine completion rate for adolescents by increasing the consistency and quality of provider recommendations. Baseline data was extracted for vaccine completion rates among patients aged 13 to 17 years. Quality improvement measures led to interventions targeting factors associated with vaccine noncompletion, in particular, weaknesses in provider recommendations and patient characteristics most strongly correlated with missed vaccination opportunities. Vaccine completion rates increased overall from 50.9% to 61.7% ( P < .05), an increase seen in both males (42.6% to 57.3%, P < .001) and females (60.0% to 66.5%, P = .04). One-dose rates improved to 88.4% for males ( P = .02) and 91.5% for females ( P = .43). Vaccination also occurred more consistently, increasing from 77.5% of visits (95% CI 71.2-83.0) before study onset to 90.9% of visits (95% CI 85.4%-94.8%) afterward ( P < .01). HPV vaccination rates can increase through focused provider-level prompts and by offering the vaccine consistently.