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October 10, 2021
10/10/2021 8:45:00 AM - 10/10/2021 9:45:00 AM
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General Anesthesia Is A "teachable Moment" For Seasonal Influenza Vaccination In Pediatric Patients: Preliminary Results
Tyler Morrissey, M.D., Tessa N. Mandler, M.D., Myron Yaster, M.D., Kim M. Strupp, M.D.
Children's Hospital Colorado, Denver, Colorado, United States
Disclosures:  T. Morrissey: None. T.N. Mandler: None. M. Yaster: None. K.M. Strupp: None.
BACKGROUND: A "teachable moment" is an event that “motivates individuals to spontaneously adopt risk-reducing health behaviors”.1 For example, some evidence suggests that major surgery for a smoking-related illness can serve as a teachable moment for smoking cessation.1 Epidemics of seasonal influenza (“flu”) occur annually and result in tens of millions of cases in the United States.2 In the 2019 epidemic, vaccination rates in adults and children were less than 50 and 60% respectively.2 We hypothesized that general anesthesia in pediatric patients is a teachable moment for parents who would agree to have their children vaccinated for flu while they underwent anesthesia.METHODS: After obtaining approval from our institution’s Organizational Research Risk and Quality Improvement Review Panel, we developed a standardized “best practice” process to offer flu vaccinations to all patients undergoing general anesthesia, Monday-Friday, at 2 of our tertiary care children’s hospitals. During patient registration in the preanesthetic preparation area, a “Best Practice Alert” was initiated on the intake nurse’s computer screen. The nurse then determined if the patient was eligible and obtained parental consent for the vaccine. A standing order for the vaccine was dispensed and placed on the patient’s chart which was administered by the operating room nurse or anesthesia practitioner after the induction of general anesthesia. Immunization documentation was printed on the patient’s after-visit summary and in MyChart ( Our primary outcome was the number of patients receiving flu vaccinations under anesthesia before and after institution of the protocol. Secondary outcomes included vaccine- and process-related complications. Data are presented as mean + SD.RESULTS: Our flu vaccination project started on October 16th, 2020 and is ongoing. In 2019-20, we administered 30 perioperative vaccines during the influenza season. In 2020-21, prior to our intervention, 30 vaccines were given over 6 weeks (mean = 5.0 + 4.0 doses/wk). After our intervention, 563 vaccines were given over 12 weeks (mean 46.9 + 16.8 doses/wk) (figure 1). There were no reported vaccine-related complications.DISCUSSION: The threat of a simultaneous coronavirus disease 2019 (COVID-19) pandemic and an epidemic of seasonal flu makes the widespread use of flu vaccines more important than ever.2 Actively offering flu vaccinations to pediatric patients undergoing general anesthesia significantly increased the number of vaccinations. This teachable moment for immunization may be a model for other childhood vaccinations and for the future COVID-19 vaccine.
Figure 1

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