Epidemiological Investigation of Influenza Vaccination Patterns of Grady Memorial Hospital (Atlanta, Georgia) Inpatients, 2018-2019 Restricted; Files Only

Abstract

Background: This study examines the challenges of influenza vaccination coverage among adults with a lens on disparities that affect gender and racial groups. The study emphasizes the significant role that hospitals play in providing comprehensive vaccination services, as they have a unique central position in healthcare. The study discusses barriers such as limited healthcare services, geographic obstacles, and financial constraints that hinder vaccination uptake among vulnerable populations, particularly those with comorbidities.

Methods: The GIVEASHOT project collected and analyzed data from Grady Memorial Hospital's inpatient encounters in 2018-2019 to understand vaccine uptake patterns and patient comorbidities. Data on demographics, medical history, ICD-10 codes, medications, and vaccines was collected to describe patient’s comorbidities and risk factor history. Additional information on historical vaccinations was also gathered from the Georgia Registry of Immunization Transaction and Services (GRITS), the statewide Immunization Information System for Georgia. From there, data analysis focused on identifying disparities in historical influenza vaccine uptake across ethnic and gender groups, examining the relationship between comorbidities, influenza vaccine status, and using various statistical tests to analyze where individuals historically obtained their vaccines. 

Results: There were demographic disparities in historical influenza vaccination coverage for Grady Memorial Hospital inpatients. Many patients were Black or African American, with slightly more male patients than female. Historical influenza vaccination uptake varied across racial groups, with higher rates among Black or African American individuals and lower rates among American Indian/Alaskan, Asian, and White individuals. The study also found significant associations between comorbidities such as diabetes, HIV, and heart disease and vaccine receipt. Historical influenza vaccine receipt often came from community sources, a few notable examples include, hospital’s (65.10%), pharmacy’s (9.87%), and medical centers (6.00%).

Discussion: With many people receiving influenza vaccines from community sources, it is important to recognize the role that hospitals, particularly safety net hospitals like Grady Memorial Hospital can play in overcoming missed opportunities for influenza vaccination, when vaccine is available in the inpatient setting.  Hospitals, on the other hand, can take advantage of their triage process to vaccinate patients who may not visit non-hospital locations, capitalizing on their role as catch-all points for patients presenting for triage.

Table of Contents

Chapter One Introduction 1

Influenza Vaccination in Healthcare Settings 1

GIVEASHOT Project 2

Chapter Two Literature Review 4

Influenza Definition 4

Influenza Epidemiology 4

Patient-Level Comorbidities and Influenza Vaccine Uptake 5

Influenza Vaccination in Hospitals 5

Barriers to Hospital-Driven Influenza Vaccination 6

Chapter Three Materials and Methods 8

Grady EMR Data 8

GRITS Data 10

Data Analysis 10

Chapter Four. Results 13

Race and Gender of the Patient Population at Grady Memorial Hospital 13

Vaccine Status of Patients at Grady Memorial Hospital Cross-Referenced with GRITS 13

Historical GRITS Flu Vaccine Status Cross-Referenced by Gender and Race 13

Historical GRITS Flu Vaccine Status Cross-Referenced by Comorbidities 14

Historical GRITS Flu Vaccine Location Sites 14

Chapter Five Discussion 15

Findings 15

Strength and Limitations 20

Chapter Six. Conclusions and Public Health Implications 21

References 23

Appendix 27

Table 1 27

Table 2 28

Table 3 29

Table 4 30

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology Health Sciences, Immunology Health Sciences, Public Health
Keyword	Safety Net Hospitals Immunizations Influenza Public Health Epidemiology
Committee Chair / Thesis Advisor	Robert A. Bednarczyk, Emory University

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