Elsevier

Journal of Pediatric Health Care

Volume 27, Issue 5, September–October 2013, Pages 327-333
Journal of Pediatric Health Care

Article
Using Reminder/Recall Systems to Improve Influenza Immunization Rates in Children With Asthma

https://doi.org/10.1016/j.pedhc.2011.11.005Get rights and content

Abstract

Introduction

Asthma is a major public health concern in the U.S. pediatric population. Children with asthma tend to fare worse when they acquire respiratory illnesses such as influenza, requiring more episodic office visits and hospitalizations than do healthy children with the same illnesses. Despite the American Academy of Pediatrics recommendation that children with chronic diseases be immunized for seasonal influenza annually, influenza immunization rates in this population peaks at < 30%. The purpose of this literature review was to examine the effectiveness of reminder/recall systems in improving influenza immunization rates among children with asthma.

Method

This literature review was conducted using PubMed, CINAHL, EMBASE, and Cochrane. Of the 178 articles found, 12 met criteria for inclusion. Articles were included if they addressed influenza vaccination in asthmatic children and “high-risk” children and considered asthmatics in the definition of “high risk.” Additionally, inclusion criteria required discussion of at least one mode of reminder method or recall method that was used to influence the rate of influenza vaccination in children with asthma. For the purposes of this review, “reminders” is defined as any action performed by health provider or representative of the health provider that was aimed at informing and/or reiterating to patients the importance of influenza vaccination for asthmatic children and/or the potential for increased morbidity with acquisition of the flu and/or availability of the vaccine. “Recall” methods included all efforts made by the health provider or his/her representative to encourage patients to return to clinics for vaccination during the influenza season. Articles were excluded if they focused on improving influenza vaccination rates in healthy children and if they used reminder/recall systems to influence vaccination against diseases other than influenza. No systematic review was found on this particular topic.

Results

Providers have used reminder and recall systems that alert patients of the need for vaccination and encourage compliance with this recommendation. Implemented techniques included verbal and mailed reminders, electronically generated alerts, and year-round scheduling of flu vaccination appointments.

Discussion

Improvements have been seen in influenza immunization rates with the implementation of reminder/recall systems; however, most have been modest. Enhancements in patient education and access to vaccination are other areas of needed improvement.

Section snippets

Methods

A literature search was conducted for articles written between 1999 and 2009; however, two older landmark studies that were very relevant (Szilagyi et al., 1992, Walter et al., 1997) also were used. The databases surveyed were PubMed, CINAHL, EMBASE, and Cochrane. The MeSH and free text search terms used were “influenza vaccine” AND “child” AND “asthma” AND “reminder” OR “recall” and yielded 178 total results. No systematic review or meta-analysis was found on this particular topic. Other

Results

The research overwhelmingly suggests that improvements in flu vaccination compliance have been noted among children with asthma as a result of the implementation of reminders or recall methods. However, the degree of impact that each intervention has on vaccination rates, whether it was by letter or telephone or delivered by a health care provider, appears to vary considerably (Table 1). Only one study based at Duke University Medical Center found no improvement in immunization rates as a

Discussion

The evidence fails to suggest that any one particular method of reminder/recall is most effective. However, it does suggest that the implementation of any form of reminder/recall effort may have a positive impact on flu vaccination rates among children with asthma. More research is needed to identify the modalities that will deliver the greatest and most well-sustained response. If health care providers are to strive toward meeting the AAP recommendations that all children between the ages of 6

Sorelle N. Jones Cooper, Graduate student, School of Nursing, Johns Hopkins University, Baltimore, MD.

References (20)

  • K. Dombkowski et al.

    Physician perspectives regarding annual influenza vaccination among children with asthma

    Ambulatory Pediatrics

    (2008)
  • M. Gaglani

    Rationale and approach to target children with asthma for annual influenza immunization

    Seminars in Pediatric Infectious Diseases

    (2002)
  • I. Paul et al.

    Improving influenza vaccination rates for children through year-round scheduling

    Ambulatory Pediatrics

    (2006)
  • Akinbami, L. (2006). The state of childhood asthma, United States, 1985-2005 (Centers for Disease Control: Advance Data...
  • Prevention of influenza: Recommendations for influenza immunization of children, 2008-2009

    Pediatrics

    (2008)
  • American Academy of Pediatrics Committee on Infectious Diseases. (2009). Recommendations for prevention and control of...
  • M. Daley et al.

    Identification and recall of children with chronic medical conditions for influenza vaccination

    Pediatrics

    (2004)
  • K. Dombkowski et al.

    Effects of missed opportunities on influenza vaccination rates among children with asthma

    Archives of Pediatrics and Adolescent Medicine

    (2006)
  • S. Esposito et al.

    Factors conditioning effectiveness of a reminder/recall system to improve influenza vaccination in asthmatic children

    Vaccine

    (2008)
  • A. Fiks et al.

    Impact of electronic health record-based alerts on influenza vaccination for children with asthma

    Pediatrics

    (2009)
There are more references available in the full text version of this article.

Cited by (27)

  • Immunizations in Children With Chronic Diseases: A State of the Science Review With Implications for Practice Change

    2022, Journal of Pediatric Health Care
    Citation Excerpt :

    Educational factors proved to be important for providers and their staff, as well as for the parents. This included a knowledge of current vaccination guidelines and understanding the benefits and risks (Costello, 2019; Geer, 2016; Jones Cooper & Walton-Moss, 2013; Kersun et al., 2013). To be comfortable making recommendations for immunizations, providers must have sufficient knowledge concerning the effect of immunizations on the child's condition.

  • Using Technology to Affect Influenza Vaccine Coverage Among Children With Chronic Respiratory Conditions

    2017, Journal of Pediatric Health Care
    Citation Excerpt :

    Providers and health care systems have taken various approaches to improving the vaccination rate. Reminder and recall systems have been used for many years in pediatric offices, but the exact process used varies widely among providers (Jones Cooper & Walton-Moss, 2013). Offices with a reminder/recall system have higher influenza vaccination rates than those without any recall system, but rates remain below recommended levels (Dombkowski, Davis, Cohn, & Clark, 2006).

  • Vaccination adherence: Review and proposed model

    2016, Journal of Infection and Public Health
    Citation Excerpt :

    In fact, parental reminders and education have been proven to be effective in increasing children's vaccination uptake. A number of review studies that addressed reminders and educational interventions to improve immunization uptake, reported that providing parents with immunization education and any other form of reminder interventions has a significant effect on increasing children's immunization rates [27,28,31]. On the other hand, the current study found only 14% of the educational factor is functional in the included apps from apps’ stores as indicted in Fig. 1.

View all citing articles on Scopus

Sorelle N. Jones Cooper, Graduate student, School of Nursing, Johns Hopkins University, Baltimore, MD.

Benita Walton-Moss, Associate Professor, School of Nursing, Johns Hopkins University, Baltimore, MD.

Conflicts of interest: None to report.

Sorelle N. Jones is currently a Family Nurse Practitioner at Unity Health Care, Inc., Washington, D.C.

View full text