Article Text

  1. K. M. Hiller1,
  2. D. R. Sullivan1
  1. 1Department of Emergency Medicine, University of Arizona, Tucson, AZ


Despite highly effective vaccines, influenza and its associated complications contribute significantly to morbidity and mortality in the United States, especially among high-risk individuals. The objective of this study is to determine whether individuals at high-risk for influenza represent a disproportionately higher percentage of emergency department (ED) visitors during the influenza season and whether their vaccination status is similar to the national percentage. Medical records of a convenience sample of all patients above the age of 6 months presenting to the ED at a university-affiliated hospital in Tucson during February 1 to 7, 2007, were reviewed (N = 1,309). Using the ACIP and CDC guidelines for vaccination, patients were stratified as (1) high risk for influenza or its complications, (2) health care worker or household contact of a high risk patient, and (3) healthy adult. Additionally, prior ED use within that season's vaccination period was determined, evaluating the potential for vaccination within the ED; 42.3% of ED patients were at high risk for influenza or its complications (US 33.5%, p < .001); 5.1% of ED patients were household contacts or health care workers (US 30.7%, p < .001); And 33.5% of high-risk patients had been vaccinated that season (US 45.7%, p < .001). Household contacts/health care workers were underrepresented in the ED sample; this is likely an artifact of incomplete retrospective data. Despite the likely undercalculation of this category, patients at high risk for influenza or complications related to influenza are overrepresented in the ED population; 13.8% of high-risk patients had had at least one visit to the ED within the preceding 3 months, representing a potential opportunity for vaccination. The ED may be a novel location in which to effectively identify and possibly immunize high-risk individuals. Benefits of ED vaccination may include subsequent reductions in mortality and morbidity as well as a decrease in ED use and hospitalization for influenza and its complications.

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