William M. Cassidy, MD¹, Dale M. Marioneaux, BS, MEd¹, Monica Pradhan, BS, MNS¹, Glenn N. Jones, PhD¹, John N. Perret, MD¹, Bayo C. Willis, BS, MPH², Mark L. Messonnier, PhD³, and Daniel Fishbein, MD⁴. (1) Department of Medicine, Louisiana State University Health Sciences Center, 5825 Airline Hwy., Baton Rouge, LA 70805, (225)358-1065, wcassi@lsuhsc.edu, (2) Immunization Services Division/ Health Services Research and Evaluation Branch, Centers for Disease Control and Prevention, 1600 Clifton Rd, NE; MS-E52, Altanta, GA 30333, (3) National Immunization Program, Centers for Disease Control and Prevention, 1600 Clifton Rd., N.E., MS E52, Atlanta, GA 30333, (4) Immunization Services Division/ Health Services Research and Evaluation Branch, CDC National Immunization Program, 1600 Clifton Rd. NE, MS E-52, Atlanta, GA 30333

BACKGROUND: Few, if any, simple interventions increase vaccination coverage among low income adults to influenza (IV), pneumococcal (PPV), and hepatitis B (HBV) vaccines. We determined the extent to which emergency department (ED) visits could be used to increase vaccination coverage. METHODS: One hundred four uninsured or Medicaid patients between 18 and 64 years with non-life threatening health problems in an ED in were assessed. Paramedical staff asked patients questions based on ACIP recommendations. If vaccine was indicated and the patient was not up-to-date (UTD), the patient was offered educational material, and randomized to free vaccination during their ED visit or two weeks later in a vaccination clinic (VC). RESULT: IV was recommended for 71% of whom 10% were UTD. Of those not UTD, 64% randomized to ED were vaccinated versus 16% randomized to VC (P=0.0001). PPV was recommended for 35% of whom 25% were UTD. Of those not UTD, 45% were vaccinated in the ED versus 13% referred to the VC (P=0.05). Hepatitis B vaccine was recommended for 40% of whom 24% were UTD. Of those not UTD, 57% were vaccinated in the ED versus 28% randomized to VC (P=0.09). CONCLUSION: High levels of coverage for flu, PPV, and HBV were achieved in the ED group following an assessment and educational intervention. Significantly more of those randomized to ED received vaccine than those randomized to VC. Assessment and vaccination of adult patients during an ED visit may be an opportunity to vaccinate patients who have fallen through society’s other safety nets.

Learning Objectives:

• Participants will be able to state the approximate proportion of ED patients agreeing to receive ACIP recommended vaccinations in the ED and what proportion are vaccinated when they are referred to another site for vaccination.

Keywords: Immunizations, Emergency Department/Room

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.