Influenza Vaccination

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		Performance Measure
		Numerator
		Denominator
		Patient Exclusions
		Data Element
		Data Sources
		National Goals, Targets or Benchmarks for Comparison
		Outcome Measures for Consideration
		Basis for Selection and Placement in Group 2
		US Public Health Service Guidelines
		References/Notes

Percentage of clients [ 1 ] with HIV infection who have received influenza vaccination within the measurement period [ 2 ]

Number of HIV-infected clients who received influenza vaccination within this time frame

Number of HIV-infected clients who had a medical visit with a provider with prescribing privileges [ 3 ] at least once in the measurement period

Patients allergic to vaccine components

1. Is the client HIV-infected? (Y/N)
   1. If yes, is there documentation in the health record that the client received influenza vaccine in the past 12 months? (Y/N)

• Electronic Medical Record/Electronic Health Record
• CAREWare, Lab Tracker or other electronic data base
• Medical record data abstraction by grantee of a sample of records
• Billing records

None available at this time

Mortality rates of bacterial pneumonia in the clinic population

Influenza viruses cause disease among all age groups. While rates of infection are highest among children, rates of serious illness and death are highest among persons aged ≥ 65 years, children less than 2 years and persons of any age who have medical conditions that place them at increased risk for complications of influenza, including HIV. [ 5 ]

Influenza vaccination is the most effective method for preventing influenza and its severe complications. Vaccination has been demonstrated to produce substantial antibody titers against influenza among vaccinated HIV-infected persons who have minimal AIDS-related symptoms and high CD4 T-lymphocyte cell counts. [ 6 ]

The measure is placed in Group 3 because it overlaps and focuses on similar aspects of care (vaccination) that were previously captured in measures included in Group 2. In addition, the data collection process is more complex because of the timing of the vaccination.

"Annual vaccination against influenza is recommended for…adults and children who have immunosuppression (including immunosuppression caused by medications or by human immunodeficiency virus)." [ 7 ]

[1] "Clients" includes all clients aged 13 years or older.

[2] Due to the unique nature of this measure, the measurement period runs from April 1-March 31.

[3] A "provider with prescribing privileges" is a health care professional who is certified in their jurisdiction to prescribe medications.

[4] Evidence of vaccination could include personal, school, physician, or immunization records or registries.

[5] Centers for Disease Control and Prevention. Prevention and Control of Influenza: Recommendations from the Advisory committee on Immunization Practices (ACIP). MMWR 2007; 56(RR#6)[1-60]. Available at: http://www.cdc.gov/mmwr/PDF/rr/rr5606.pdf .

[6] Ibid.

[7] Ibid.