Byung Kwang Yoo

Additional Visit Burden for Universal Influenza Vaccination of US School-Aged Children and Adolescents

OBJECTIVEnTo estimate the additional primary care visits needed for universal influenza vaccination of all US children and adolescents if all vaccinations occurred in primary care settings.nnnDESIGNnCross-sectional design.nnnSETTINGnWell-child care and other visits to primary care practices from the 2003-2004 Medical Expenditure Panel Survey.nnnPARTICIPANTSnChildren aged 5 to 18 years (n = 3047) with a usual source of care. Main Outcome Measure Percentage of children needing 0, 1, or 2 additional visits to be immunized against influenza in a 3-, 4-, or 5-month vaccination window.nnnRESULTSnIn a 3-month window, if only well-child care visits were used for first immunization, 97% of 5- and 6-year-olds and 98% of 7- and 8-year-olds would need 1 or 2 additional visits for complete vaccination; 95% of 9- to 18-year-olds would need 1 visit. If instead all visits were used for immunization, 90% of 5- and 6-year-olds and 91% of 7- and 8-year-olds would need 1 or 2 visits; 78% of 9- to 18-year-olds would need 1 visit. Expanding the window to 4 or 5 months slightly reduces the need for additional visits. Nationally, using all opportunities for vaccination, 42 million additional visits would be needed in a generous 5-month window.nnnCONCLUSIONSnMost children and adolescents would need additional visits for universal influenza vaccination, even if all existing visits were used as vaccination opportunities. Efficient methods for vaccinating large numbers of children and adolescents are needed if primary care practices are to provide influenza vaccine for all children.

Effects of mass media coverage on timing and annual receipt of influenza vaccination among Medicare elderly.

OBJECTIVEnTo measure the association between mass media coverage on flu-related topics and influenza vaccination, regarding timing and annual vaccination rates, among the nationally representative community-dwelling elderly.nnnDATA SOURCEnYears 1999, 2000, and 2001 Medicare Current Beneficiary Survey.nnnSTUDY DESIGNnCross-sectional survival analyses during each of three influenza vaccination seasons between September 1999 and December 2001. The outcome variable was daily vaccine receipt. We measured daily media coverage by counting the number of television program transcripts and newspaper/wire service articles, including keywords of influenza/flu and vaccine/shot shortage/delay. All models covariates included three types of media, vaccine supply, and regional/individual factors.nnnPRINCIPAL FINDINGSnInfluenza-related reports in all three media sources had a positive association with earlier vaccination timing and annual vaccination rate. Four television networks reports had most consistent positive effects in all models, for example, shifting the mean vaccination timing earlier by 1.8-4.1 days (p<.001) or increasing the annual vaccination rate by 2.3-7.9 percentage points (p<.001). These effects tended to be greater when reported in a headline rather than in text only and if including additional keywords, for example, vaccine shortage/delay.nnnCONCLUSIONSnTiming and annual receipt of influenza vaccination appear to be influenced by media coverage, particularly by headlines and specific reports on shortage/delay.

Association Between Medicaid Reimbursement and Child Influenza Vaccination Rates

OBJECTIVE: We examined associations between influenza vaccination rates and Medicaid reimbursement rates for vaccine administration among poor children who were eligible for Medicaid (<100% of the federal poverty level in all states). METHODS: We analyzed 3 consecutive National Immunization Surveys (NISs) to assess influenza vaccination rates among nationally representative children 6 to 23 months of age during the 2005–2006 (unweighted N = 12 885), 2006–2007 (unweighted N = 9238), and 2007–2008 (unweighted N = 11 785) influenza seasons (weighted N = 3.3–4.0 million per season). We categorized children into 3 income levels (poor, near-poor, or nonpoor). We performed analyses with full influenza vaccination as the dependent variable and state Medicaid reimbursement rates (continuous covariate ranging from

Cost of Universal Influenza Vaccination of Children in Pediatric Practices

2 to

How to improve influenza vaccination rates in the U.S.

17.86 per vaccination) and terms with income levels as key covariates. RESULTS: In total, 21.0%, 21.3%, and 28.9% of all US children and 11.7%, 11.6%, and 18.8% of poor children were fully vaccinated in the 2006, 2007, and 2008 NISs, respectively. Multivariate analyses of all 3 seasons found positive significant (all P < .05) associations between state-level Medicaid reimbursement and influenza vaccination rates among poor children. A

Influenza vaccine supply and racial/ethnic disparities in vaccination among the elderly

10 increase, from

Self-Efficacy as a Mediator Between Maternal Depression and Child Hospitalizations in Low-Income Urban Families

8 per influenza vaccination (the US average) to

Mother–Child Interactions and the Associations with Child Healthcare Utilization in Low-Income Urban Families

18 (the highest state reimbursement), in the Medicaid reimbursement rate was associated with 6.0-, 9.2-, and 6.4-percentage point increases in full vaccination rates among poor children in the 2006, 2007, and 2008 NIS analyses, respectively. CONCLUSION: Medicaid reimbursement rates are strongly associated with influenza vaccination rates.

Effects of an Ongoing Epidemic on the Annual Influenza Vaccination Rate and Vaccination Timing Among the Medicare Elderly: 2000-2005

OBJECTIVES: The goals were to estimate nationally representative pediatric practices costs of providing influenza vaccination during the 2006–2007 season and to simulate the costs pediatric practices might incur when implementing universal influenza vaccination for US children aged 6 months to 18 years. METHODS: We surveyed a stratified, random sample of New York State pediatric practices (N = 91) to obtain information from physicians and office managers about all practice resources associated with provision of influenza vaccination. We estimated vaccination costs for 2 practice sizes (small and large) and 3 geographic areas (urban, suburban, and rural). We adjusted these data to obtain national estimates of the total practice cost (in 2006 dollars) for providing 1 influenza vaccination to children aged 6 months to 18 years. RESULTS: Among all respondents, the median total cost per vaccination was

Impacts of informal caregiver availability on long-term care expenditures in OECD countries

28.62 (interquartile range: