Dataset Information

Agreement among sources of adult influenza vaccination in the age of immunization information systems.

ABSTRACT:

Introduction

Many vaccination studies rely on self-reported vaccination status, with its inherent biases. Accuracy of influenza vaccination self-report has been evaluated periodically, typically using the medical record as the gold standard. The burgeoning of electronic medical records (EMRs) and immunization information systems (IISs) and the rise of adult vaccine administration in community pharmacies suggest the need for a reevaluation of self-reported vaccination status.

Methods

Vaccination data from self-report, the state IIS, the health system EMR and other sources were compared for participants in outpatient and inpatient influenza vaccine effectiveness studies for four seasons (2016-2017 to 2019-2020). Agreement among the sources was calculated along with sensitivity and specificity. Tests for trend assessed changes in completeness of the Pennsylvania - Statewide IIS (PA-SIIS) data over time.

Results

With self-report as the gold standard, agreement with the local EMR, PA-SIIS, and all sources was 62%, 77% and 85%, respectively. Sensitivity of the EMR was 42% (95% CI = 41, 43) and specificity was 91% (90, 92). With PA-SIIS-as the gold standard, agreement with the local EMR and all sources was 77% and 78%, respectively. Sensitivity of all sources combined was 96% (95, 97) and specificity was (63% (62, 64). Capture of influenza vaccinations in the IIS has not consistently improved over time, with a significant increase among children (P = 0.001), no change among working-age adults and a decrease among older adults (P = 0.004). However, PA-SIIS provided the largest percentage of verified vaccines (69.3%) compared with EMR (43.3%) and other sources (12.4%).

Conclusion

Both self-report and PA-SIIS are good estimates of actual vaccine uptake. When high accuracy data are required, such as for vaccine effectiveness studies, triangulation using multiple sources should be conducted.

SUBMITTER: Nowalk MP

PROVIDER: S-EPMC8653902 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Agreement among sources of adult influenza vaccination in the age of immunization information systems.

Nowalk Mary Patricia MP D'Agostino Helen Eleni Aslanidou HEA Zimmerman Richard K RK Saul Sean G SG Susick Michael M Raviotta Jonathan M JM Sax Theresa M TM Balasubramani G K GK

Vaccine 20211027 47

<h4>Introduction</h4>Many vaccination studies rely on self-reported vaccination status, with its inherent biases. Accuracy of influenza vaccination self-report has been evaluated periodically, typically using the medical record as the gold standard. The burgeoning of electronic medical records (EMRs) and immunization information systems (IISs) and the rise of adult vaccine administration in community pharmacies suggest the need for a reevaluation of self-reported vaccination status.<h4>Methods</ ...[more]

PMID: 34716041

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Project description:ContextUse of Immunization information systems (IISs) by providers can improve vaccination rates by identifying missed opportunities. However, provider reporting of children's vaccination histories to IISs remains suboptimal.ObjectiveTo assess factors associated with provider reporting to an IIS.DesignAnalysis of 2006-2012 National Immunization Survey (NIS) and NIS-Teen data. NIS and NIS-Teen are ongoing random-digit-dial telephone surveys of households with children and adolescents, respectively, followed by a mail survey to providers to obtain the patient's vaccination history.Setting and participantsA total of 115 285 children aged 19 to 35 months and 83 612 adolescents aged 13 to 17 years and their immunization providers in the United States.Main outcome measuresThe percentage of children and adolescents with 1 or more providers reporting to or obtaining vaccination information from their local IISs. Multivariable logistic regression was used to examine patient and provider factors associated with provider reporting to IISs and adjusted prevalence of children and adolescents with 1 or more providers reporting to IISs.ResultsIn 2012, 79.4% of children and 77.4% of adolescents had 1 or more providers report any of their vaccination data to an IIS, and 41.9% of children and 51.5% of adolescents had providers who obtained any of their vaccination histories from an IIS. During 2006-2012, children and adolescents were more likely to have any of their vaccination data reported to an IIS if they received care from all public versus all private providers (children: 84.4% vs 69.6%, P < .0001; adolescents: 84.6% vs 66.4%, P < .0001), had 1 or more providers who ordered vaccines from a state or local health department (children: 76.7% vs 59.5%, P < .0001; adolescents: 77.0% vs 55.6%, P < .0001), or had 1 or more providers obtain vaccination information from the IIS (children: 86.1% vs 71.2%, P < .0001; adolescents: 83.7% vs 64.6%, P < .0001).ConclusionsHealth department staff should target providers less likely to use IIS services, including private providers, and providers not ordering vaccines from health departments to ensure they use IIS services.

Project description:BackgroundA variety of circumstances can influence how widely vaccination during pregnancy is accepted. Healthcare workers (HCWs) are often seen as the main resource for recommending vaccination. The purpose of the current study was to determine whether Italian HCWs advise and recommend pregnant people to receive the influenza vaccinations, as well as what knowledge and attitudes affect their practices. A secondary aim of the study was to evaluate HCWs' knowledge and attitudes towards COVID-19 vaccination.MethodsThis cross-sectional study, took place between August 2021 and June 2022 in a randomly selected sample of HCWs in three Italian regions. The target population comprised obstetricians-gynecologists, midwives and primary care physicians, who provide medical care to pregnant people. The questionnaire consisted of 19 items divided into 5 parts gathered information about the participants' sociodemographic and professional characteristics, general knowledge about vaccinations during pregnancy, and vaccine-preventable diseases (VPDs), attitudes and practices towards immunization, and strategies to potentially increase vaccination uptake during pregnancy.ResultsAmong the participants, 78.3% knew that pregnant people are at increased risk of severe complications from influenza, 57.8% that the influenza vaccine is not provided only in the 2nd/3rd trimester of pregnancy and 60% that pregnancy is a risk factor for severe COVID-19 infection. Of the enrolled HCWs, 10.8% believed that the potential risks of vaccines administered during pregnancy are greater than the benefits. An even higher proportion of the participants was unsure (24.3%) or did not deem (15.9%) that vaccinating against influenza during pregnancy reduces the risk of preterm birth and abortion. Moreover, 11.8% of the sample did not believe or was uncertain that COVID-19 vaccine must be offered to all pregnant people. Among HCWs, 71.8% advised women about influenza vaccination during pregnancy, and 68.8% recommended getting vaccinated against influenza during pregnancy. Results showed that good knowledge and positive attitudes were the strongest factors positively associated with advising women about influenza vaccination during pregnancy.ConclusionThe gathered data showed that a sizable portion of the HCWs lacks up-to-date knowledge, underestimates the risks of contracting a VPD, and overestimates the risks of vaccine side effects during pregnancy. The findings shed light on such attributes useful to promote adherence to evidence-based recommendations among HCWs.

Project description:Background/objectivesCommunity pharmacies may not consistently check patients' immunization records from Immunization Information Systems (IIS) before administering vaccines. Therefore, this study aimed to identify key factors associated with vaccine records retrieval from IIS among community pharmacies.MethodsA cross-sectional survey of 9446 members of the United States National Community Pharmacists Association was conducted from September-November 2022. There were 492 responses (response rate 5.2 %) received. The analysis included 202 participants who provided immunization services in 2021, administered vaccines besides COVID-19 or influenza, and completed ≥80 % of the questionnaire. The dependent variable was participants' self-reported frequency of retrieving immunization records from IIS (categorized as high or low IIS users). The independent variables considered were participant/pharmacy characteristics, IIS knowledge and perceptions about innovation characteristics, process, and inner settings, as identified by the Consolidated Framework for Implementation Research. Exploratory factor analysis identified ten perception scales, and all had Cronbach's Alpha coefficient of >0.70.ResultsApproximately 65 % of the respondents were high IIS users ("frequently"/"always") while 35 % were low IIS users ("never"/"rarely"/"occasionally"). A bivariate analyses of the relationship between the dependent and independent variables indicated significant differences in job title, state requirement for documentation in IIS, and eight scales: perceived benefit of IIS in consolidating patient records, optimizing immunization service delivery process, perceived IIS usability, process of engaging staff in IIS implementation, leadership support in encouraging IIS utilization, team values, open communications, and organizational needs fulfillment. A multivariable logistic regression analysis revealed that process optimization (p = .009) and leadership support (p = .018) were the two significant predictors of being in the high IIS user group when accounting for other variables.ConclusionInterventions to encourage independent community pharmacies to retrieve vaccine records from IIS should focus on enhancing the efficiency of the IIS process and leadership support.

Dataset Information

Agreement among sources of adult influenza vaccination in the age of immunization information systems.

Introduction

Methods

Results

Conclusion

Publications

Agreement among sources of adult influenza vaccination in the age of immunization information systems.

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