Vaccination Status Of Patients Research Articles

Flu Vaccines and Patient Decision Making: What We Need to Know

To describe and compare patient-perceived barriers and motivators and decision-making conflict between two groups of hospitalized patients, those who received flu vaccines and those who did not. Data collection included extracting data from databases and mailing two surveys to 436 discharged patients. One hundred eight patients participated in the study. Top motivators for obtaining a flu vaccine included previous vaccination (93%) and provider recommendation (62%). Top barriers included fear of side effects from the vaccine (35%) and fear of contracting the flu (30%). Motivators, barriers, and patient decisional conflict differed depending upon the patient's vaccination status. Given the potential negative consequences of contracting the flu, prevention is the best strategy. Prevention is contingent upon motivating patients to obtain an annual flu vaccine. Recommending flu vaccinations, offering vaccinations in convenient locations free of charge, and discussing perceived barriers with patients may increase vaccinations among high-risk patients. Helping to clarify the advantages and disadvantages from the patient's perspective may decrease decisional conflict and increase vaccination rates.

A comparison of multiple data sources to identify vaccinations for veterans with spinal cord injuries and disorders

Monitoring vaccination activity requires regular access to information about patient vaccination status. This report describes our experience using multiple Department of Veterans Affairs (VA) data sources to determine availability and completeness of vaccination information for veterans with spinal cord injuries and disorders (SCI&D). Administrative and clinical databases were limited to coding vaccine administration, undercounted vaccinations, and were unable to account for whether the vaccine was offered and the reasons for nonreceipt. Medical record review provided more detail but was labor intensive and costly. Patient surveys provided the richest information but were costly, time-consuming, and based on a sample of patients. Agreement was poor between data sources. This report suggests that while VA is well positioned to use national databases for clinical care decisions and to inform policy, vaccination data were incomplete. Electronic records must include data that are consistently entered and validated before they can be useful for care management and decision making.

Standards for Child and Adolescent Immunization Practices

Standards for Child and Adolescent Immunization Practices

Standards for adult immunization practices

Since the Standards for Adult Immunization Practices were first published in 1990, healthcare researchers and providers have learned important lessons on how to better achieve and maintain high vaccination rates in adults. The success rate of childhood immunization far exceeds the success rate of adult immunization. Thus, information and practices that will produce higher success rates for adult vaccination are crucial, resulting in overall societal cost savings and substantial reductions in hospitalizations and deaths. The Standards, which were developed to encourage the best immunization practices, represent the collective efforts of more than 100 people from more than 60 organizations. The revised Standards are more comprehensive than the 1990 Standards and focus on the accessibility and availability of vaccines, proper assessment of patient vaccination status, opportunities for patient education, correct procedures for administering vaccines, implementation of strategies to improve vaccination rates, and partnerships with the community to reach target patient populations. The revised Standards are recommended for use by all healthcare professionals and all public and private sector organizations that provide immunizations for adults. All who are involved in adult immunization should strive to follow the Standards in order to create the same level of success achieved by childhood vaccination programs and to meet the Healthy People 2010 goals.

Efficacy of influenza vaccine among elderly patients by physical activity status

Although many studies have shown the usefulness of influenza vaccine in elderly in-patients, the efficacy of vaccination with regard to the daily physical activities of patients has not been fully evaluated. To address this issue, we correlated the use of medical resources with vaccination status in patients categorized according to their daily activity levels. The subjects comprised 237 in-patients at or above 51 years of age, who were hospitalized in the long-term care unit of a Japanese hospital between January and March, 1999. The vaccination status and medical resources use (i.e., oral antibiotics, injected antibiotics, blood cell count, chest X-ray) of each patient were recorded, and the patients were assigned to three subgroups, based on daily life activity scores. Vaccinated in-patients in the 'bed-bound' category required fewer medical resources, i.e., oral antibiotics (-2.29 days,P<0.05), injected antibiotics (-5.02 days,P<0.001), blood cell counts (-4.66 times,P<0.001), and chest X-rays (-4.31 times,P<0.001), compared with unvaccinated in-patients. There were no significant differences in treatment parameters between vaccinated and unvaccinated patients in the 'partly limited' or 'no limitation' categories. It is suggested that influenza vaccination significantly reduces the need for medical treatment only among those in-patients who are the least physically active. Further studies are required to replicate these findings, and to elucidate the underlying reasons for this reduction.

Recommendations, usage and efficacy of immunizations for the elderly.

Significant levels of older-adult mortality and morbidity are associated with vaccine-preventable diseases, specifically influenza and pneumococcal disease. Even though current guidelines for this age group recommend a single vaccination against pneumococcal pneumonia, an annual influenza vaccination and a combined tetanus-diphtheria toxoid booster every 10 years after completion of a primary series, immunization levels remain extremely low. This article presents information regarding usage, efficacy and cost-effectiveness of these vaccines. Physician non-compliance and misinformation, negative patient attitudes and a shortage of effective programs for vaccine delivery account for vaccine underutilization. Recommendations from health care providers significantly affect whether a person will be immunized. Increased vaccine usage was noted in clinic-based programs that initiated organizational or administrative interventions, such as patient and physician reminders, physician-performance feedback, medical-record checklists and the use of non-physician health care staff to monitor patient vaccination status and to dispense vaccines. Providing organized education and vaccination programs in institutional and public settings may also help target the older-adult population. The future success of adult immunization will depend not only on increased professional and public awareness but also on the development of new approaches to vaccine delivery.

Vaccination status of patients in an outbreak of acute poliomyelitis.

Considerable interest has been aroused in the degree of protection afforded by partial or complete poliomyelitis vaccination to persons who became infected with the virus of poliomyelitis. Related to this is the probability that commercially prepared poliomyelitis vaccine is of inconstant potency and therefore produces inconstant degrees of protection. A high incidence of acute poliomyelitis occurred in the middle Tennessee area during the summer of 1959 and made possible a study of the effects of vaccination with killed virus vaccine on the characteristics of the disease. An effort was made to relate vaccination status to the degree of paralysis. Patient Material Sixty-nine patients were seen during the acute phase of the disease and are included in this study. The clinical diagnosis was based on the characteristic historical, physical, and laboratory findings of acute poliomyelitis. For each patient, the diagnosis was confirmed by virus isolation and/or serological data. Patients who were