Influenza and pneumococcal disease vaccinations: Is there a role for prevention in the emergency department?

Background: Influenza and pneumococcal disease are vaccine-preventable illnesses and account for significant morbidity and mortality worldwide. Influenza vaccination reduces influenza-related mortality and pneumococcus vaccination reduces the incidence of invasive pneumococcal disease. Our objective was to determine what proportion of adult patients presenting to the emergency department qualify for and are willing to be vaccinated against influenza and pneumococcal disease during their visit. Methods: Our study used a convenience sample of adult patients presenting to the emergency department who were able to communicate in English. Participating patients consented to be screened for demographic characteristics, vaccination status, risk factors for complications from influenza and pneumococcal disease, and contra-indications to vaccination. Critically ill patients and patients in severe pain were excluded. Results: A total of 254 of 358 patients who met the inclusion criteria completed the Vaccination in Emergency Survey for a response rate of 71%. We found 20% of patients at high risk for influenza complications were unvaccinated and willing to be vaccinated in the emergency department, while 15% of patients were at high risk for pneumococcal disease complications and were unvaccinated and willing to be vaccinated in the emergency department. In the study population overall, 83% of patients were at high risk for complications from influenza and 58% were at high risk for complications from pneumococcal disease. Conclusions: Our study demonstrates that patients presenting to the emergency department include many at high risk for complications from influenza and pneumococcal disease, and that some are willing to be vaccinated during their visit. Our findings suggest that these patients are not being reached in other ways and could be a target group for vaccination campaigns.