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Randomized Quality Improvement Trial of Opting-In Versus Opting-Out to Increase Influenza Vaccination Rates during Pregnancy

tetano

Editor, Senior Moderator
AJP Rep. 2018 Jul;8(3):e161-e167. doi: 10.1055/s-0038-1668566. Epub 2018 Aug 28.
[h=1]Randomized Quality Improvement Trial of Opting-In Versus Opting-Out to Increase Influenza Vaccination Rates during Pregnancy.[/h] Wootton SH[SUP]1[/SUP], Blackwell SC[SUP]2[/SUP], Saade G[SUP]3[/SUP], Berens PD[SUP]2[/SUP], Hutchinson M[SUP]2[/SUP], Green CE[SUP]4[/SUP], Sridhar S[SUP]5[/SUP], Elam KM[SUP]4[/SUP], Tyson JE[SUP]4[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] Introduction  Despite strong recommendations, only 40.6% of pregnant women attending two prenatal clinics were vaccinated against influenza during the 2009 pandemic. We tested whether an opting-out approach would improve vaccine uptake. Methods  We conducted a randomized quality improvement (QI) trial to compare opting-out with conventional opting-in consent for influenza immunization. Women age ≥ 18 years attending the University of Texas Health Science Center at Houston (UTHealth) or UT-Medical Branch (UTMB) prenatal clinics during the 2010-2011 influenza season, were eligible. Results  We enrolled 280 women (140 UTHealth, 140 UTMB). Both groups had similar mean age (26.0 ? 5.5 years), mean gestational age (19.4 ? 9.5 weeks), and percent with underlying health conditions (20.7%). Vaccination rates with opting-in and opting-out were similar among all (83 vs. 84%), UTHealth (87 vs. 93%), and UTMB patients (79 vs.76%) ( p  > 0.05). In subsamples of patients assessed, consent strategy did not significantly affect maternal recall of information provided. Conclusion  While prenatal influenza vaccination uptake doubled from the 2009-2010 influenza season, opting-out did not perform better than opting-in, a conclusion opposite that we would have reached had this been a nonconcurrent trial. Vaccination rates dropped posttrial; hence, continued research is needed to increase the prenatal influenza immunizations.


[h=4]KEYWORDS:[/h] consent forms; immunization; influenza vaccines; pregnancy; vaccines

PMID: 30167346 PMCID: PMC6113052 DOI: 10.1055/s-0038-1668566
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