Abstract 396: Combating Inpatient Vaccine Hesitancy: I Raised The Rates In My Cardiac Patients

Abstract

Introduction: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide. Influenza infections in patients with underlying CVD are associated with an increased risk of cardiovascular (CV) events. Influenza immunization is a global prevention strategy; however, more hospital-based policies are needed to combat the alarming rise of vaccine hesitancy across all age groups in the States. Our objective was to increase immunization rates in patients with CVD. Methods: Qualitative improvement project using FADE model to design and implement an in-hospital intervention for adults with CV comorbidities between November 2019-February 2020. A 5-question survey was administered to CV stepdown unit nurses to identify vaccination barriers. An immunization promotion intervention using the motivational interview model was performed by residents upon receipt of daily immunization updates in patients with unknown influenza vaccine status. The primary objective was to provide bedside education to vaccine-hesitant patients during their hospital course or upon discharge in the outpatient setting. Amongst unvaccinated patients, we tracked potential CV complications using the HCA database for patients admitted during the current flu season. Results: We identified 5,680 patients that met inclusion criteria for the 2018-2019 and current flu season admitted to CV stepdown unit for comparison. At the end of our pilot study, 91 patients were willing to receive the vaccine in the outpatient setting, and 73 patients opted to receive their influenza vaccination on the floors during their stay. Notable barriers found during the study (1) data collection for CV complications for the current flu season is ongoing, (2) physicians were not able to place orders for the patients that received the intervention, and (3) insufficient nursing immunization documentation for continued management. After overcoming institutional barriers, and in light of CDC’s findings during the 2018-19 influenza season; where it was found that 57% of adults ≥ 65 required hospitalization and accounted for 75% of all influenza-associated deaths. Our executive leadership will implement new policies to support nursing leadership in joining our crusade and implement our approach for a hospital-wide intervention next flu season as Florida is currently the third least vaccinated state as of 2019. Conclusions: Inpatient vaccine promotion via hospital-based vaccine programs should be utilized to combat vaccine hesitancy as misinformation continues to permeate the public sphere. The new threat of SARS-CoV-2 is a sobering reminder that we must not falter in our resolve to reach the masses. Further studies are needed to understand the role of influenza immunization campaigns to improve hospital policy and increase influenza vaccine rates to decrease CV events in patients with preexisting CVD.