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Want a Flu Vaccine? I Thought You’d Never Ask!

May 21, 2024

Written by Megan Hilbert

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In underserved populations, where the Emergency Department may be patients’ greatest contact with the healthcare system, simply asking may increase seasonal influenza vaccination.

You mean if I just ask I might make a change? And more isn’t necessarily better? Yep. Keep it simple stupid.
This was a three-group, prospective, cluster-randomized controlled trial of clinically stable patients at six academic, community, and safety net hospitals across the United States. The three groups were control (usual care), Intervention M (messaging including video, one-page flyer, scripted message in addition to vaccine acceptance question and provider notification), and Intervention Q (no messaging, vaccine acceptance question and provider notification). Primary outcome measured was receipt of influenza vaccine at 30 days comparing the control to Intervention M. The authors found an adjusted difference of 25.1 percentage points with the intervention (95%CI 17-33.2). This corresponds to a number needed to treat (NNT) of 4 (95%CI 3-6).  Secondary outcome was comparison of control to Intervention Q and the two intervention groups against each other. In secondary analysis there was a 16.7 percentage point adjusted difference between the control group and Intervention Q (95%CI 9.4-24.0) which corresponded to a NNT of 6 (95%CI 4-10). There was not a statistically significant difference between the two intervention groups.

I applaud the authors for investigating this. We have known that the ED is unique in its ability to reach underserved populations with regard to a multitude of healthcare concerns. This study shows that we can do even more good for public health by simply assessing interest in vaccination.

How will this change my practice?
This study shows that I don’t have to overcomplicate the assessment of vaccination interest. By simply asking I could make a change in public health; sign me up.

Promotion of Influenza Vaccination in the Emergency Department. NEJM Evid 2024;3(4) DOI: 10.1056/EVIDoa2300197