Vaccinating High-Risk Pediatric Patients and Their Families in the Hospital Setting: Give It a Shot!

BACKGROUND: Hospitalization and hospital-based clinics confer an opportunity to target high-risk patients and their families who would benefit from vaccination. METHODS: CHOC Children’s Hospital is a tertiary-care hospital in Southern California with 11,995 admissions in 2016, including 1,580 hematology/oncology (HO) admissions. We examined the trend in influenza vaccine administration in hospitalized and HO patients over the last decade. We assessed the trend in Tdap and influenza vaccine administration among parents of hospitalized children. We correlated those trends with disease outbreaks in the community and educational and programmatic efforts at our institution. RESULTS: After educational efforts, the influenza vaccination rate in 2017 compared with 2006 increased 13-fold in hospitalized patients and increased 9-fold among hospitalized HO patients. During the H1N1 pandemic in 2009, influenza vaccination rates increased 470% from the year prior (Figure 1). The number of influenza vaccines administered in the clinic to HO patients was 494 and 408 in 2015–2016 and 2016–2017, respectively. Following program initiation, the number of Tdap vaccines administered to parents during their child’s hospitalization increased from 57 doses in 2013 to 118 doses in 2016. The trend in vaccination roughly followed pertussis outbreak cases (Figure 2). The number of influenza vaccines administered to parents of HO patients during their child’s clinic visit increased from 44 doses given in 2015–2016 to 306 doses given in 2016–2017 (Figure 3). At our institution, among staff we achieved a 98% vaccination rate for Tdap and influenza in 2017. There were no serious adverse events reported after patient, parent or staff vaccination during this time period. CONCLUSION: Missed opportunities for vaccination of high-risk children include hospitalization and specialty clinic visits. Creating a culture of vaccination and public perception of vaccine importance during outbreaks can increase the influenza vaccination rate among high-risk, hospitalized and HO patients. Programs targeting families of high-risk patients are an opportunity to cocoon a vulnerable population. Vaccination of hospitalized children, their parents and staff is safe in these settings. DISCLOSURES: All authors: No reported disclosures.