DR. BURKE, section editor for Journal Club, is chairman of the department of pediatrics at Saint Agnes Hospital, Baltimore. He is a contributing editor for <italic>Contemporary Pediatrics</italic>. He has nothing to disclose in regard to affiliations with
Investigators set out to document rates of influenza vaccination among children with asthma, along with patterns of missed opportunities to vaccinate, by retrospectively analyzing administrative claims in the Michigan Medicaid program during two recent, successive influenza seasons.
During the 2001-2002 influenza season, approximately 17% of 4,358 children between 5 and 18 years of age who had persistent asthma had an influenza vaccination; for about 73% of those not vaccinated, at least one opportunity (an office visit) had been missed during that influenza season. During the 2002-2003 season, about 22% of children who had asthma had an influenza vaccination; at least one opportunity had been missed for about 69% of those not vaccinated. Fewer than 10% of children were vaccinated in both seasons; the great majority (71%) were not vaccinated in either season.
As for those missed opportunities, about three quarters of the children included in the analysis had at least one office visit in the 2001-2002 influenza season and about 65% had two or more visits. Data were similar for the 2002-2003 influenza season. And most children (64.5%) had an office visit during both influenza seasons. The initial missed opportunity for about half of the children was in October in both seasons; the first missed opportunity occurred by the end of November for nearly three quarters. Among children with no office visits, many who were unvaccinated paid a visit to the emergency department during influenza season-another missed opportunity.
Commentary During this month, whether you are seeing children in the office, ED, or hospital inpatient unit, keep this article in mind. We can improve the numbers during this flu season.