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Published in: BMC Health Services Research 1/2019

Open Access 01-12-2019 | Influenza Vaccination | Research article

Exploring strategies to promote influenza vaccination of children with medical comorbidities: the perceptions and practices of hospital healthcare workers

Authors: Vanessa Ma, Pamela Palasanthiran, Holly Seale

Published in: BMC Health Services Research | Issue 1/2019

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Abstract

Background

To explore how the influenza vaccine is promoted and delivered to children with medical comorbidities in the hospital setting, as well as the facilitators of and barriers to vaccination from the healthcare worker perspective.

Methods

Semi-structured interviews were conducted with staff members (n = 17) at a paediatric hospital in Sydney, Australia between April and July 2018. This included nurses, clinical nurse consultants, pediatricians and department heads. The interviews were transcribed and analysed iteratively to generate the major themes.

Results

Approaches used to promote and/or deliver the influenza vaccine varied among the participants. Some described the vaccine as an ingrained component of their clinical consultation. Others acknowledged that there was missed opportunities to discuss or provide the vaccine, citing competing priorities as well as a lack of awareness, time and resources. Participants perceived that some parents had concerns about safety and appropriateness of the vaccine for their child. While there was some support for sending reminders and/or educating patients through the hospital, there were differing perspectives on whether tertiary centres should be delivering the vaccine.

Conclusion

Hospital-based interventions to increase vaccine uptake must consider the needs of staff. Easily accessible information and increased awareness of the recommendations among staff may lead to improved uptake in this hospital. Additional resources would be required to increase on-site delivery of the vaccine.
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Literature
1.
go back to reference Australian Technical Advisory Group on Immunisation (ATAGI). The Australian Immunisation Handbook 10th ed. Canberra: Australian Government Department of Health; 2013. Australian Technical Advisory Group on Immunisation (ATAGI). The Australian Immunisation Handbook 10th ed. Canberra: Australian Government Department of Health; 2013.
3.
go back to reference Li-Kim-Moy J, Yin JK, Blyth CC, Kesson A, Booy R, Cheng AC, et al. Influenza hospitalizations in Australian children. Epidemiol Infect. 2017;145(7):1451–60.CrossRef Li-Kim-Moy J, Yin JK, Blyth CC, Kesson A, Booy R, Cheng AC, et al. Influenza hospitalizations in Australian children. Epidemiol Infect. 2017;145(7):1451–60.CrossRef
4.
go back to reference Blyth CC, Macartney KK, Hewagama S, Senenayake S, Friedman ND, Simpson G, et al. Influenza epidemiology, vaccine coverage and vaccine effectiveness in children admitted to sentinel Australian hospitals in 2014: the influenza complications alert network (FluCAN). Eurosurveillance. 2016;21(30):30301.CrossRef Blyth CC, Macartney KK, Hewagama S, Senenayake S, Friedman ND, Simpson G, et al. Influenza epidemiology, vaccine coverage and vaccine effectiveness in children admitted to sentinel Australian hospitals in 2014: the influenza complications alert network (FluCAN). Eurosurveillance. 2016;21(30):30301.CrossRef
5.
go back to reference Cheng AC, Holmes M, Dwyer DE, Irving LB, Korman TM, Senenayake S, et al. Influenza epidemiology in patients admitted to sentinel Australian hospitals in 2015: the influenza complications alert network. Commun Dis Intell Q Rep. 2016;40(4):E521–E6.PubMed Cheng AC, Holmes M, Dwyer DE, Irving LB, Korman TM, Senenayake S, et al. Influenza epidemiology in patients admitted to sentinel Australian hospitals in 2015: the influenza complications alert network. Commun Dis Intell Q Rep. 2016;40(4):E521–E6.PubMed
6.
go back to reference Newcombe J, Kaur R, Wood N, Seale H, Palasanthiran P, Snelling T. Prevalence and determinants of influenza vaccine coverage at tertiary pediatric hospitals. Vaccine. 2014;32(48):6364–8.CrossRef Newcombe J, Kaur R, Wood N, Seale H, Palasanthiran P, Snelling T. Prevalence and determinants of influenza vaccine coverage at tertiary pediatric hospitals. Vaccine. 2014;32(48):6364–8.CrossRef
7.
go back to reference Norman DA, Danchin M, Van Buynder P, Moore HC, Blyth CC, Seale H. Caregiver's attitudes, beliefs, and experiences for influenza vaccination in Australian children with medical comorbidities. Vaccine. 2019;37(16):2244–8.CrossRef Norman DA, Danchin M, Van Buynder P, Moore HC, Blyth CC, Seale H. Caregiver's attitudes, beliefs, and experiences for influenza vaccination in Australian children with medical comorbidities. Vaccine. 2019;37(16):2244–8.CrossRef
8.
go back to reference Pandolfi E, Marino MG, Carloni E, Romano M, Gesualdo F, Borgia P, et al. The effect of physician's recommendation on seasonal influenza immunization in children with chronic diseases. BMC Public Health. 2012;12:984.CrossRef Pandolfi E, Marino MG, Carloni E, Romano M, Gesualdo F, Borgia P, et al. The effect of physician's recommendation on seasonal influenza immunization in children with chronic diseases. BMC Public Health. 2012;12:984.CrossRef
9.
go back to reference Lin CJ, Nowalk MP, Zimmerman RK, Ko F-S, Zoffel L, Hoberman A, et al. Beliefs and attitudes about influenza immunization among parents of children with chronic medical conditions over a two-year period. J Urban Health. 2006;83(5):874–83.CrossRef Lin CJ, Nowalk MP, Zimmerman RK, Ko F-S, Zoffel L, Hoberman A, et al. Beliefs and attitudes about influenza immunization among parents of children with chronic medical conditions over a two-year period. J Urban Health. 2006;83(5):874–83.CrossRef
10.
go back to reference Poehling KA, Speroff T, Dittus RS, Griffin MR, Hickson GB, Edwards KM. Predictors of Influenza Virus Vaccination Status in Hospitalized Children. Pediatrics. 2001;108(6):e99-e.CrossRef Poehling KA, Speroff T, Dittus RS, Griffin MR, Hickson GB, Edwards KM. Predictors of Influenza Virus Vaccination Status in Hospitalized Children. Pediatrics. 2001;108(6):e99-e.CrossRef
11.
go back to reference Mirza A, Subedar A, Fowler SL, Murray DL, Arnold S, Tristram D, et al. Influenza vaccine: awareness and barriers to immunization in families of children with chronic medical conditions other than asthma. South Med J. 2008;101(11):1101–5.CrossRef Mirza A, Subedar A, Fowler SL, Murray DL, Arnold S, Tristram D, et al. Influenza vaccine: awareness and barriers to immunization in families of children with chronic medical conditions other than asthma. South Med J. 2008;101(11):1101–5.CrossRef
12.
go back to reference Sampson R, Wong L, Macvicar R. Parental reasons for non-uptake of influenza vaccination in young at-risk groups: a qualitative study. Br J Gen Pract. 2011;61(588):e386–91.CrossRef Sampson R, Wong L, Macvicar R. Parental reasons for non-uptake of influenza vaccination in young at-risk groups: a qualitative study. Br J Gen Pract. 2011;61(588):e386–91.CrossRef
13.
go back to reference Daley MF, Beaty BL, Barrow J, Pearson K, Crane LA, Berman S, et al. Missed opportunities for influenza vaccination in children with chronic medical conditions. Arch Pediatr Adolesc Med. 2005;159(10):986–91.CrossRef Daley MF, Beaty BL, Barrow J, Pearson K, Crane LA, Berman S, et al. Missed opportunities for influenza vaccination in children with chronic medical conditions. Arch Pediatr Adolesc Med. 2005;159(10):986–91.CrossRef
14.
go back to reference Smith MJ, McFalls D, Hendricks J, Watkins J, Moore C, Peacock G, et al. Influenza vaccination practices of physicians and caregivers of children with neurologic and neurodevelopmental conditions - United States, 2011-12 influenza season. Morb Mortal Wkly Rep. 2013;62(36):744–6. Smith MJ, McFalls D, Hendricks J, Watkins J, Moore C, Peacock G, et al. Influenza vaccination practices of physicians and caregivers of children with neurologic and neurodevelopmental conditions - United States, 2011-12 influenza season. Morb Mortal Wkly Rep. 2013;62(36):744–6.
15.
go back to reference Newcombe JP, Kaur R, Wood N, Seale H, Palasanthiran P, Snelling TL. Paediatrician beliefs and practices around influenza vaccination. J Paediatr Child Health. 2017;53(7):711–4.CrossRef Newcombe JP, Kaur R, Wood N, Seale H, Palasanthiran P, Snelling TL. Paediatrician beliefs and practices around influenza vaccination. J Paediatr Child Health. 2017;53(7):711–4.CrossRef
16.
go back to reference Brotherton J, Wang H, Schaffer A, Quinn H, Menzies R, Hull B, et al. Vaccine preventable diseases and vaccination coverage in Australia, 2003 to 2005. Commun Dis Intell Q Rep. 2007;31:S1.PubMed Brotherton J, Wang H, Schaffer A, Quinn H, Menzies R, Hull B, et al. Vaccine preventable diseases and vaccination coverage in Australia, 2003 to 2005. Commun Dis Intell Q Rep. 2007;31:S1.PubMed
17.
go back to reference Rickert D, Santoli J, Shefer A, Myrick A, Yusuf H. Influenza vaccination of high-risk children: what the providers say. Am J Prev Med. 2006;30(2):111–8.CrossRef Rickert D, Santoli J, Shefer A, Myrick A, Yusuf H. Influenza vaccination of high-risk children: what the providers say. Am J Prev Med. 2006;30(2):111–8.CrossRef
18.
go back to reference Dombkowski KJ, Leung SW, Clark SJ. Physician perspectives regarding annual influenza vaccination among children with asthma. Ambul Pediatr. 2008;8(5):294–9.CrossRef Dombkowski KJ, Leung SW, Clark SJ. Physician perspectives regarding annual influenza vaccination among children with asthma. Ambul Pediatr. 2008;8(5):294–9.CrossRef
19.
go back to reference Neuzil KM, Wright PF, Mitchel EF Jr, Griffin MR. The burden of influenza illness in children with asthma and other chronic medical conditions. J Pediatr. 2000;137(6):856–64.CrossRef Neuzil KM, Wright PF, Mitchel EF Jr, Griffin MR. The burden of influenza illness in children with asthma and other chronic medical conditions. J Pediatr. 2000;137(6):856–64.CrossRef
20.
go back to reference Wijlaars LPMM, Gilbert R, Hardelid P. Chronic conditions in children and young people: learning from administrative data. Arch Dis Child. 2016;101(10):881.CrossRef Wijlaars LPMM, Gilbert R, Hardelid P. Chronic conditions in children and young people: learning from administrative data. Arch Dis Child. 2016;101(10):881.CrossRef
21.
go back to reference Dombkowski KJ, Davis MM, Cohn LM, Clark SJ. Effect of missed opportunities on influenza vaccination rates among children with asthma. Arch Pediatr Adolesc Med. 2006;160(9):966–71.CrossRef Dombkowski KJ, Davis MM, Cohn LM, Clark SJ. Effect of missed opportunities on influenza vaccination rates among children with asthma. Arch Pediatr Adolesc Med. 2006;160(9):966–71.CrossRef
22.
go back to reference NVIVO. Qualitative data analysis software. Version 10. Doncaster, Vic, Australia: QSR International Pty Ltd; 2012. NVIVO. Qualitative data analysis software. Version 10. Doncaster, Vic, Australia: QSR International Pty Ltd; 2012.
23.
go back to reference Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef
24.
go back to reference Hofstetter AM, Robinson JD, Lepere K, Cunningham M, Etsekson N, Opel DJ. Clinician-parent discussions about influenza vaccination of children and their association with vaccine acceptance. Vaccine. 2017;35(20):2709–15.CrossRef Hofstetter AM, Robinson JD, Lepere K, Cunningham M, Etsekson N, Opel DJ. Clinician-parent discussions about influenza vaccination of children and their association with vaccine acceptance. Vaccine. 2017;35(20):2709–15.CrossRef
25.
go back to reference Tuckerman J, Misan S, Salih S, Joseph Xavier B, Crawford NW, Lynch J, et al. Influenza vaccination: uptake and associations in a cross-sectional study of children with special risk medical conditions. Vaccine. 2018;36(52):8138–47.CrossRef Tuckerman J, Misan S, Salih S, Joseph Xavier B, Crawford NW, Lynch J, et al. Influenza vaccination: uptake and associations in a cross-sectional study of children with special risk medical conditions. Vaccine. 2018;36(52):8138–47.CrossRef
26.
go back to reference Willis A, Swann J, Thompson J. Childhood long-term conditions in primary care: a qualitative study of practitioners’ views. Br J Gen Pract. 2015;65(638):e593–600.CrossRef Willis A, Swann J, Thompson J. Childhood long-term conditions in primary care: a qualitative study of practitioners’ views. Br J Gen Pract. 2015;65(638):e593–600.CrossRef
27.
go back to reference Biezen R, Grando D, Mazza D, Brijnath B. Why do we not want to recommend influenza vaccination to young children? A qualitative study of Australian parents and primary care providers. Vaccine. 2018;36(6):859–65.CrossRef Biezen R, Grando D, Mazza D, Brijnath B. Why do we not want to recommend influenza vaccination to young children? A qualitative study of Australian parents and primary care providers. Vaccine. 2018;36(6):859–65.CrossRef
28.
go back to reference Merckx J, McCormack D, Quach C. Improving influenza vaccination in chronically ill children using a tertiary-care based vaccination clinic: is there a role for the live-attenuated influenza vaccine (LAIV)? Vaccine. 2016;34(6):750–6.CrossRef Merckx J, McCormack D, Quach C. Improving influenza vaccination in chronically ill children using a tertiary-care based vaccination clinic: is there a role for the live-attenuated influenza vaccine (LAIV)? Vaccine. 2016;34(6):750–6.CrossRef
29.
go back to reference Philips L, Young J, Williams LA, Cooke M, Rickard C. Opportunistic immunisation in the emergency department: a survey of staff knowledge, opinion and practices. Australas Emerg Nurs J. 2014;17(2):44–50.CrossRef Philips L, Young J, Williams LA, Cooke M, Rickard C. Opportunistic immunisation in the emergency department: a survey of staff knowledge, opinion and practices. Australas Emerg Nurs J. 2014;17(2):44–50.CrossRef
30.
go back to reference Austvoll-Dahlgren A, Helseth S. Public health nurses’ barriers and facilitators to the use of research in consultations about childhood vaccinations. Scand J Caring Sci. 2012;26(2):271–8.CrossRef Austvoll-Dahlgren A, Helseth S. Public health nurses’ barriers and facilitators to the use of research in consultations about childhood vaccinations. Scand J Caring Sci. 2012;26(2):271–8.CrossRef
31.
go back to reference Nowak GJ, Sheedy K, Bursey K, Smith TM, Basket M. Promoting influenza vaccination: insights from a qualitative meta-analysis of 14 years of influenza-related communications research by U.S. Centers for Disease Control and Prevention (CDC). Vaccine. 2015;33(24):2741–56.CrossRef Nowak GJ, Sheedy K, Bursey K, Smith TM, Basket M. Promoting influenza vaccination: insights from a qualitative meta-analysis of 14 years of influenza-related communications research by U.S. Centers for Disease Control and Prevention (CDC). Vaccine. 2015;33(24):2741–56.CrossRef
32.
go back to reference Mohanty S, Carroll-Scott A, Wheeler M, Davis-Hayes C, Turchi R, Feemster K, et al. Vaccine hesitancy in pediatric primary care practices. Qual Health Res. 2018;28(13):2071–80.CrossRef Mohanty S, Carroll-Scott A, Wheeler M, Davis-Hayes C, Turchi R, Feemster K, et al. Vaccine hesitancy in pediatric primary care practices. Qual Health Res. 2018;28(13):2071–80.CrossRef
33.
go back to reference Martin E. Improving influenza vaccination rates for pediatric asthmatics by use of an asthma educational tool and a patient electronic care system. Clin Pediatr. 2008;47(6):588–92.CrossRef Martin E. Improving influenza vaccination rates for pediatric asthmatics by use of an asthma educational tool and a patient electronic care system. Clin Pediatr. 2008;47(6):588–92.CrossRef
34.
go back to reference Aigbogun NW, Hawker JI, Stewart A. Interventions to increase influenza vaccination rates in children with high-risk conditions—a systematic review. Vaccine. 2015;33(6):759–70.CrossRef Aigbogun NW, Hawker JI, Stewart A. Interventions to increase influenza vaccination rates in children with high-risk conditions—a systematic review. Vaccine. 2015;33(6):759–70.CrossRef
35.
go back to reference Szilagyi PG, Rodewald LE, Savageau J, Yoos L, Doane C. Improving influenza vaccination rates in children with asthma: a test of a computerized reminder system and an analysis of factors predicting vaccination compliance. Pediatrics. 1992;90(6):871–5.PubMed Szilagyi PG, Rodewald LE, Savageau J, Yoos L, Doane C. Improving influenza vaccination rates in children with asthma: a test of a computerized reminder system and an analysis of factors predicting vaccination compliance. Pediatrics. 1992;90(6):871–5.PubMed
36.
go back to reference Pappano D, Humiston S, Goepp J. Efficacy of a pediatric emergency department–based influenza vaccination program. Arch Pediatr Adolesc Med. 2004;158(11):1077–83.CrossRef Pappano D, Humiston S, Goepp J. Efficacy of a pediatric emergency department–based influenza vaccination program. Arch Pediatr Adolesc Med. 2004;158(11):1077–83.CrossRef
37.
go back to reference Elia S, Perrett K, Newall F. Providing opportunistic immunisations for at-risk inpatients in a tertiary paediatric hospital. J Spec Pediatr Nurs. 2017;22(1):e12167.CrossRef Elia S, Perrett K, Newall F. Providing opportunistic immunisations for at-risk inpatients in a tertiary paediatric hospital. J Spec Pediatr Nurs. 2017;22(1):e12167.CrossRef
38.
go back to reference Wood NJ, Cashman PM. Influenza immunisation program at three tertiary paediatric hospitals in NSW in 2010. N S W Public Health Bull. 2011;22(11–12):230–2.CrossRef Wood NJ, Cashman PM. Influenza immunisation program at three tertiary paediatric hospitals in NSW in 2010. N S W Public Health Bull. 2011;22(11–12):230–2.CrossRef
39.
go back to reference Dube E, Gagnon D, Huot C, Pare R, Jacques S, Kossowski A, et al. Influenza immunization of chronically ill children in pediatric tertiary care hospitals. Hum Vaccin Immunother. 2014;10(10):2935–41.CrossRef Dube E, Gagnon D, Huot C, Pare R, Jacques S, Kossowski A, et al. Influenza immunization of chronically ill children in pediatric tertiary care hospitals. Hum Vaccin Immunother. 2014;10(10):2935–41.CrossRef
40.
go back to reference Brown M, Sheppeard V, Gabriel S, Thomas J. Description of the Western Sydney and Nepean Blue Mountains local health districts' influenza prevention programme. Intern Med J. 2013;43(7):760–6.CrossRef Brown M, Sheppeard V, Gabriel S, Thomas J. Description of the Western Sydney and Nepean Blue Mountains local health districts' influenza prevention programme. Intern Med J. 2013;43(7):760–6.CrossRef
Metadata
Title
Exploring strategies to promote influenza vaccination of children with medical comorbidities: the perceptions and practices of hospital healthcare workers
Authors
Vanessa Ma
Pamela Palasanthiran
Holly Seale
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2019
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-019-4742-5

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