High influenza vaccination coverage in children with high-risk conditions during a vaccine shortage.

OBJECTIVE To assess whether pediatric practices with a system to identify and recall children with high-risk conditions (HRCs) could maintain high influenza vaccination coverage levels among these children during a vaccine shortage year. DESIGN Observational study using data from a computerized billing database and an electronic immunization information system. SETTING Four Denver pediatric practices during the 2003-2004 and 2004-2005 influenza seasons. PARTICIPANTS Children aged 24 to 72 months with and without HRCs. Main Exposure The vaccine shortage of the 2004-2005 influenza season. MAIN OUTCOME MEASURES Proportion of children with and without HRCs who were immunized and the timing of influenza immunization in nonshortage (2003-2004) and shortage (2004-2005) seasons. RESULTS In the 2003-2004 season, 770 of 1166 children with HRCs (66.0%) were immunized and, in the 2004-2005 season, 656 of 1053 (62.3%) were immunized. Although vaccination coverage did not significantly decrease for children with HRCs during the 2004-2005 season (P = .07), coverage for healthy children decreased from 43.8% (4435/10 117) to 29.5% (3066/10 387) (P < .001). After the priority group recommendation in October 2004, the practices provided few vaccines to healthy children, whereas children with HRCs continued to receive the vaccine. CONCLUSION Pediatric practices with a system to identify and recall children with HRCs can target these children for receipt of the influenza vaccine and maintain high vaccination coverage, despite a vaccine shortage that may result in decreased vaccine coverage in healthy children.