How do we (meaning you!) improve the low influenza vaccination rate among children who have asthma?

A report issued late this past summer by the National Foundation for Infectious Diseases (NFID) provides practical strategies and tools to help pediatricians and other health care professionals increase what NFID considers an alarmingly low rate of influenza immunization among children who have asthma—part of an initiative to address immunization barriers and improve parental education about the importance of influenza vaccination for all children with asthma. Influenza vaccination has been shown to reduce morbidity and mortality in this high-risk pediatric population.

Despite long-standing Centers for Disease Control and Prevention (CDC) recommendations, estimates are that only one third of children who have asthma are immunized each year against influenza. Viral respiratory infections, including influenza, often lead to wheezing in asthmatic children, and can increase airway obstruction and lower respiratory tract inflammation.

"Strategies and Tools to Improve Influenza Vaccination," subtitled "Influenza and Children with Asthma: Identifying and Overcoming Barriers to Improved Influenza Vaccination Rates in this High-risk Population," discusses key interventions to increasing the vaccination rate in this high-risk target group, including:

• Securing commitments from senior management of an organization (such as the group practice's medical director or hospital administration)
• Assigning a person (or team) to manage and coordinate an influenza immunization program
• Educating parents and both clinical and nonclinical staff in a practice throughout the year about the benefits of immunization
• Recommending annual influenza vaccination during every patient encounter
• Using reminder-recall systems to identify and target asthmatic children within the practice for influenza vaccination
• Enhancing access to vaccination (such as reducing out-of-pocket cost and waiting room time for parents, and holding vaccine clinics). NFID has also developed tools to help support implementation of these approaches, including an ICD-9 code list to promote identification children who have asthma, a vaccine clinic checklist, and an fact sheet for parents about influenza vaccination.