Strategies for increasing influenza vaccination rates among a high-risk cardiovascular population

Abstract

Epidemics of influenza result in approximately 114,000 hospitalizations per year, as well as 10,000 to 40,000 deaths per year. Patients with cardiovascular disease risk factors are at increased risk for developing influenza, and at a higher risk for hospitalizations, complications, or death secondary to influenza virus. Ninety percent of deaths due to influenza occur in older adults, the majority of which have cardiovascular disease. Vaccination against influenza is the most effective means for reducing the effect of the influenza virus. Increasing vaccination rates in high-risk cardiovascular populations is essential. The purpose of this study is to evaluate the effectiveness of different strategies for increasing vaccination rates, specifically telephone versus mail reminder methods. Patients seen at the University of Mississippi Medical Center Hypertension Clinic, who have multiple cardiovascular disease risk factors, were randomized to one of three groups: telephone reminder, mail reminder, or control. A total of 1546 patients were randomized. Of the total number of patients recommended for vaccination, 515 received telephone reminders, 515 received mail reminders, and 516 served as controls. Patients in both the telephone and mail reminder groups received the same educational information regarding influenza vaccination. Rates of vaccination are compared among the three groups. Many patients do not realize influenza may lead to death, while others believe vaccination is ineffective or unnecessary. Other patients simply forget to be revaccinated annually. Incorporating educational patient information into reminder strategies should raise patient awareness and diminish these barriers to vaccination. Through these efforts, overall vaccination rates will be improved, ultimately resulting in reduced complications and death.