Randomized trial of an alternate human papillomavirus vaccine administration schedule in college-aged women.

Background: Human papillomavirus (HPV) vaccine is effective against HPV types 16 and 18, which cause 70% of cervical cancers. The three-dose vaccination schedule at 0, 2, and 6 months may be inconvenient for college-aged women. This study assessed noninferiority of the immune response to an alternate vaccination schedule at 0, 2, and 12 months.

Establish the habit: influenza vaccination for health care personnel.

Influenza vaccination of health care personnel (HCP) is a patient safety issue, but the national rate is only 42%. Following an intervention in 2006-2007, HCP in a large health system were surveyed. Self-reported influenza vaccination rate was 61.

Understanding adult vaccination in urban, lower-socioeconomic settings: influence of physician and prevention systems.

Purpose: Vaccination rates for pneumococcal polysaccharide vaccine (PPV) and influenza vaccine are relatively low in disadvantaged urban populations. This study was designed to assess which physician and practice characteristics might explain differences in rates across physicians.

Methods: PPV and influenza vaccination rates were determined for 2,021 patients aged 65 years and older receiving care from 30 physicians in 17 practices surveyed about their office systems for providing adult immunizations.

Factorial design for improving influenza vaccination among employees of a large health system.

Objective: As healthcare personnel (HCP) influenza vaccination becomes a quality indicator for healthcare facilities, effective interventions are needed. This study was designed to test a factorial design to improve HCP vaccination rates.

Design: A before-after trial with education, publicity, and free and easily accessible influenza vaccines used a factorial design to determine the effect of mobile vaccination carts and incentives on vaccination rates of HCP, who were divided into groups on the basis of their level of patient contact (ie, business and/or administrative role, indirect patient contact, and direct patient contact).

Self-reported influenza vaccination rates among health care workers in a large health system.

Background: The national health care worker (HCW) influenza vaccination rate is only 42% despite recommendations that HCWs receive influenza vaccine to prevent influenza among patients.

Methods: Following an educational intervention to improve influenza vaccination in 6 facilities in a large health system (University of Pittsburgh Medical Center), surveys were mailed to 1200 nonphysician HCWs to determine factors related to influenza vaccination and inform the following year's intervention. HCWs were proportionally sampled with oversampling for minority HCWs, and analyses were weighted to adjust for the clustered nature of the data.

Raising adult vaccination rates over 4 years among racially diverse patients at inner-city health centers.

Objectives: To increase adult immunizations at inner-city health centers serving primarily minority patients.

Design: A before-after trial with a concurrent control.

Setting: Five inner-city health centers.

Economic evaluation of standing order programs for pneumococcal vaccination of hospitalized elderly patients.

Background: Standing order programs (SOPs), which allow for vaccination without an individual physician order, are the most effective mechanism to achieve high vaccination rates. Among the suggested settings for the utilization of SOPs are hospital inpatient units, because they provide care for those most likely to benefit from vaccination. The cost-effectiveness of this approach for elderly hospitalized persons is unknown.

Assessing disparities in adult vaccination using multimodal approaches in primary care offices: methodology.

Racial disparities in invasive pneumococcal disease and pneumococcal polysaccharide vaccination (PPV) persist despite significant progress. One reason may be that minority patients receive primary care at practices with fewer resources, less efficient office systems, and different priorities. The purposes of this paper are: (1) to describe the recruitment of a diverse array of primary care practices in Pittsburgh, Pennsylvania serving white and minority patient populations, and the multimodal data collection process that included surveys of key office personnel, observations of practice operations and medical record reviews for determining PPV vaccination rates; and (2) to report the results of the sampling strategy.

Designing and implementing a hospital-based vaccine standing orders program.

Purpose: An inpatient pneumococcal polysaccharide vaccine (PPV) vaccination program was designed and implemented to meet federal and state regulatory requirements and national vaccination goals.

Summary: In 2002, the Centers for Medicare and Medicaid Services published a final rule removing the federal requirement for an individual patient physician-signed order for the pneumococcal and influenza vaccines in Medicare- and Medicaid- participating hospitals. This statute authorized implementation of standing orders programs (SOPs) in health care institutions.

Improving influenza vaccination rates of high-risk inner-city children over 2 intervention years.

Purpose: Influenza immunization rates among children with high-risk medical conditions are disappointingly low, and relatively few data are available on raising rates, particularly over 2 years. We wanted to determine whether interventions tailored to individual practice sites improve influenza immunization rates among high-risk children in inner-city health centers over 2 years.

Method: A before-after trial to improve influenza immunization of children was conducted at 5 inner-city health centers (residencies and faith-based).

Interventions over 2 years to increase influenza vaccination of children aged 6-23 months in inner-city family health centers.

The purposes of this study were to test the ability of tailored interventions to raise influenza immunization rates and assess the effect on timely receipt of other vaccines. We conducted a before/after trial over 2 years to increase influenza vaccination rates of patients 6-23 months old in five inner-city family health centers serving low-income children with a sixth site as a concurrent control. Influenza vaccination rates improved significantly from a baseline of 4.

Overcoming barriers to establishing an inpatient vaccination program for pneumococcus using standing orders.

Objectives: To identify and classify barriers to establishing a standing orders program (SOP) for adult pneumococcal vaccination in acute care inpatient facilities and to provide recommendations for overcoming these roadblocks. Vaccination rates in hospitals with SOPs are generally higher than those in hospitals that require individual physician orders. The array of solutions drawn from our experience in different hospital settings should permit many types of facilities to anticipate and overcome barriers, allowing a smoother transition from initiation to successful implementation of an inpatient pneumococcal vaccination SOP.

Vaccine criticism on the World Wide Web.

Background: The incidence of vaccine-preventable diseases is directly related to the number of unvaccinated children. Parents who refuse vaccination of their children frequently express concerns about vaccine safety. The Internet can influence perceptions about vaccines because it is the fastest growing source of consumer health information.