The following is a summary of “Evaluation of missed influenza vaccination opportunities in the emergency department,” published in the June 2023 issue of Emergency Medicine by Simon, et al.

Seasonal influenza significantly burdens healthcare resources, with many hospitalizations and deaths reported annually. Despite widespread influenza vaccination efforts in various healthcare settings, the emergency department (ED) represents a missed opportunity to vaccinate high-risk patients who need access to routine preventive care. While previous studies have described the feasibility of implementing ED-based influenza vaccination programs, they have yet to explore the potential health resource impact fully. For a study, researchers sought to assess the potential impact of an influenza vaccination program in an urban adult ED population using historical patient data.

They conducted a retrospective study of all encounters in tertiary care hospital-based ED and three freestanding EDs during two influenza seasons (October 1 – April 30) over two years, 2018-2020. Data were collected from the electronic medical record (EPIC®). They screened all ED encounters using specific ICD 10 codes during the study period. Patients who had confirmed positive influenza tests but no documented influenza vaccination for the current season were identified and evaluated for any ED visits at least 14 days before the influenza-positive contact and throughout the concurrent influenza season. The emergency department visits were viewed as missed chances for immunization and may have prevented the later meeting with influenza-positive patients. For patients who missed their chance to get vaccinated, the use of medical resources, such as later ED visits and inpatient admissions, was evaluated.

During the study period, 116,140 ED encounters were screened for inclusion. Among them, 2,115 were influenza-positive encounters involving 1,963 unique patients. Among these patients, 418 individuals (21.3%) had missed opportunities to be vaccinated during prior ED encounters at least 14 days before the influenza-positive encounter. Among those with missed vaccination opportunities, 60 patients (14.4%) experienced subsequent influenza-related encounters, including 69 ED visits and 7 inpatient admissions.

Patients presenting to the ED with influenza often had chances to be vaccinated during previous ED encounters. Implementing an ED-based influenza vaccination program could reduce the burden of influenza-related healthcare resources by preventing future ED visits and hospitalizations.

Source: sciencedirect.com/science/article/abs/pii/S073567572300133X