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Cynthia M. Rand, MD, MPH; Peter G. Szilagyi, MD, MPH; Byung-Kwang Yoo, MD, PhD; Peggy Auinger, MS; Christina Albertin, MPH; Margaret S. Coleman, PhD

Arch Pediatr Adolesc Med. 2008;162(11):1048-1055.

Objective  To estimate the additional primary care visits needed for universal influenza vaccination of all US children and adolescents if all vaccinations occurred in primary care settings.

Design  Cross-sectional design.

Setting  Well-child care and other visits to primary care practices from the 2003-2004 Medical Expenditure Panel Survey.

Participants  Children aged 5 to 18 years (n = 3047) with a usual source of care.

Main Outcome Measure  Percentage of children needing 0, 1, or 2 additional visits to be immunized against influenza in a 3-, 4-, or 5-month vaccination window.

Results  In a 3-month window, if only well-child care visits were used for first immunization, 97% of 5- and 6-year-olds and 98% of 7- and 8-year-olds would need 1 or 2 additional visits for complete vaccination; 95% of 9- to 18-year-olds would need 1 visit. If instead all visits were used for immunization, 90% of 5- and 6-year-olds and 91% of 7- and 8-year-olds would need 1 or 2 visits; 78% of 9- to 18-year-olds would need 1 visit. Expanding the window to 4 or 5 months slightly reduces the need for additional visits. Nationally, using all opportunities for vaccination, 42 million additional visits would be needed in a generous 5-month window.

Conclusions  Most children and adolescents would need additional visits for universal influenza vaccination, even if all existing visits were used as vaccination opportunities. Efficient methods for vaccinating large numbers of children and adolescents are needed if primary care practices are to provide influenza vaccine for all children.

Author Affiliations: Departments of Pediatrics (Drs Rand and Szilagyi and Mss Auinger and Albertin) and Community and Preventive Medicine (Dr Yoo), University of Rochester School of Medicine and Dentistry, Rochester, New York; and Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Coleman).

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