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Dante Pappano, MD; Sharon Humiston, MD, MPH; Julius Goepp, MD

Arch Pediatr Adolesc Med. 2004;158:1077-1083.

Background  Influenza vaccination effectively reduces influenza-related morbidity in children but is underused. The pediatric emergency department is a potential intervention point for increasing influenza vaccination in children.

Objective  To assess the effectiveness of a pediatric emergency department–based influenza vaccination program.

Design  A prospective, randomized, controlled clinical trial.

Participants  We recruited subjects from persons seeking pediatric emergency care at a large tertiary care hospital during influenza vaccination season in 2002. Eligible subjects were themselves or had a household member at increased risk for influenza complications, according to Advisory Committee on Immunization Practices guidelines.

Interventions  We randomly assigned subjects by family to the "vaccine offered" group or the "education only" group. We educated both groups about influenza illness, the risks and benefits of influenza vaccination, and how to receive influenza vaccination outside the study. We offered influenza vaccination to the "vaccine offered" group and later obtained telephone reports of the postinfluenza-season vaccination status of both groups.

Results  Four hundred thirty-seven subjects completed the study (238 from the "vaccine offered" group, 199 from the "education only" group). At follow-up, the percentage of influenza-vaccinated subjects in the "vaccine offered" group was greater than in the "education only" group. This was true for pediatric patients (57% vs 36%) (relative risk, 1.59; 95% confidence interval, 1.16-2.16) as well as for their accompanying adult and child family members (75% vs 34%) (relative risk, 2.19; 95% confidence interval, 1.64-2.92).

Conclusion  A pediatric emergency department–based influenza vaccination program increases vaccination of targeted children and family members who use the emergency department during influenza vaccination season.

Author Affiliations: Division of Pediatric Emergency Medicine, Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry (Drs Pappano and Humiston), and Lupine Creative Consulting (Dr Goepp), Rochester, NY.

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