Improving influenza vaccination rates in pregnant women.

OBJECTIVE To determine whether a provider-focused reminder improved vaccination rates as compared with no reminder. STUDY DESIGN This was a retrospective cohort study comparing vaccination rates among pregnant patients seen in October and November 2003 (no reminder) and October and November 2005 (provider-focused reminder). Charts of all patients presenting for prenatal care during those months were reviewed for vaccination order. Vaccination rates were calculated and compared by year, provider, age, race, education, primary language, insurance type, and presence or absence of medical risk factors. RESULTS A total of 1,367 records were reviewed: 504 from 2003 and 863 from 2005. Overall vaccination rate increased from 15-52% with a provider-focused reminder in place. In our study population medical risk factors were identified in 396 patients (29%). Vaccination rates for patients with medical risk factors increased from 18-47%. All provider groups demonstrated significant increases in the rates of vaccination with a reminder, however, there were no differences in age, race, education, primary language, or insurance. CONCLUSION Although a low-cost, provider-focused reminder improved vaccination rates to 52%, additional measures including patient and provider education, dedicated vaccination clinics, and standing orders will be needed to achieve the ACOG goal of 100% vaccination.