Successful implementation of a combined pneumococcal and influenza vaccination program in a Canadian emergency department

Abstract

Objectives: To determine the proportion of patients vaccinated with pneumococcal (PVAX) and influenza (IVAX) vaccines under an emergency department (ED) vaccination program, that would not otherwise have been vaccinated by other primary care resources.

Methods: This prospective cohort study was performed in a tertiary care academic centre. A questionnaire was administered to all consenting ED patients who met screening eligibility criteria to receive either IVAX or PVAX. Eligible unvaccinated patients who did not plan on receiving vaccination elsewhere were offered one or both of the vaccines and, if agreeable, were immunized in the ED.

Results: During the 4-week study period, 754 patients (36% of all presenting ED patients) were eligible for vaccination with one or both vaccines. Of these 525 (70%) consented to participate in the study and completed a questionnaire. Of the 525 participants, 289 (55% of IVAX eligible patients; 95% confidence interval [CI], 51%-59%) were unvaccinated against influenza that year and did not plan on being vaccinated elsewhere and 277 (60% of PVAX eligible patients; 95% CI, 56%-64%) were unvaccinated against pneumococcus and did not plan on being vaccinated elsewhere. IVAX was administered to 187 patients (65% penetration; 95% CI, 59%-70%), and PVAX was administered to 165 patients (60% penetration; 95% CI, 54%-65%). Overall vaccine penetration was 46% (95% CI, 42%-50%) in the study participants and 32% (95% CI, 29%-35%) for the entire ED screened and eligible group. Reasons for vaccination refusal included concerns about benefit, side effects, and the desire to discuss vaccination with their primary care physician.

Conclusions: An ED-based program can result in the vaccination of a significant proportion of patients eligible for IVAX and/or PVAX who would otherwise likely go unprotected.