Evaluation of Mass Influenza Immunization Clinics in Puerto Rico During the 2013-14 Influenza Season Open Access

Rao, Anirudh (2016)

Permanent URL: https://etd.library.emory.edu/concern/etds/w0892b36r?locale=en
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Abstract

Background: During the seasonal influenza epidemic of 2013-2014, the Puerto Rico Department of Health held mass vaccination clinics across the island in response to increased influenza activity. To provide information that can be used to tailor future mass vaccination campaigns, this study examined factors associated with influenza vaccination at these mass vaccination clinics versus vaccinations provided at other facilities, as well as vaccinations given during mass vaccination clinics early in the season compared to those given later in the season.

Methods: Data were obtained from the Puerto Rico Immunization Registry (PRIR) for the 2013-2014 influenza season. Log-binomial regression was used to investigate the associations between age, sex, race and insurance status with vaccination at early mass clinics (compared to later mass clinics), and vaccination at mass clinics (compared to non-mass vaccination sites).

Results: The PRIR reported 267,273 influenza vaccinations provided in Puerto Rico during the 2013-2014 influenza season. After adjusting for all other factors, vaccinations that were less likely to be given at early mass vaccination clinics than at late mass vaccination clinics were those given to persons of Other Race (aPR 0.86, relative to Whites). Vaccinations given to Black children in the PRIR were more likely to be received at mass vaccination clinics than at non-mass vaccination sites (aPR 1.78, relative to White children). In addition, vaccinations that were less likely to be received at mass vaccination clinics than at non-mass vaccination sites were those given to children 6 months-4 years (aPR 0.35, relative to 13-18 year olds) and those given to children under Medicaid, or to children without insurance (aPR 0.52 and aPR 0.55, respectively, relative to privately insured children).

Conclusions: : There were sociodemographic differences in vaccinations given at early mass vaccination clinics compared to those given at late mass vaccination clinics, as well as those given to Puerto Rican children at mass vaccination clinics compared to those vaccinations given at other venues. The Puerto Rico Department of Health can use these findings to modify their influenza vaccination strategies during future epidemics, through directing vaccine stocks to providers who vaccinate children.

Table of Contents

Table of Contents

Background/Literature Review 1

Epidemiology of Influenza 1

Influenza Vaccine 4

Influenza Vaccine Recommendations and Trends in Influenza Vaccination 6

Influenza and Mass Vaccination 9

2013-2014 Influenza Season and Response in Puerto Rico 10

Manuscript 15

Abstract 15

Introduction 16

Methods 17

Results 21

Discussion 28

Public Health Implications and Future Directions 34

Appendix 37

References 38

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