Advertisement
Review Article| Volume 70, ISSUE 2, P227-241, April 2023

Download started.

Ok

Influenza Vaccine Hesitancy

Scope, Influencing Factors, and Strategic Interventions
  • Ashley B. Stephens
    Affiliations
    Division of Child and Adolescent Health, Department of Pediatrics, Columbia University, Vagelos College of Physicians and Surgeons and NewYork-Presbyterian, 622 West 168th Street - VC 417, New York, NY 10032, USA
    Search for articles by this author
  • Annika M. Hofstetter
    Affiliations
    Department of Pediatrics, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 981952, USA

    Seattle Children’s Research Institute, M/S CURE-4, PO Box 5371, Seattle, WA 98145, USA
    Search for articles by this author
  • Melissa S. Stockwell
    Correspondence
    Corresponding author. 622 West 168th Street - VC 417, New York, NY 10032.
    Affiliations
    Division of Child and Adolescent Health, Department of Pediatrics, Columbia University, Vagelos College of Physicians and Surgeons and NewYork-Presbyterian, 622 West 168th Street - VC 417, New York, NY 10032, USA

    Department of Population and Family Health, Mailman School of Public Health, Columbia University, 60 Haven Avenue, New York, NY 10032, USA
    Search for articles by this author

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.

      Subscribe:

      Subscribe to Pediatric Clinics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. Victorian Health Reform.
        (Available at) (Accessed on May 10, 2022)
        • Spier R.E.
        Perception of risk of vaccine adverse events: a historical perspective.
        Vaccine. 2001; 20: S78-S84
        • Kempe A.
        • Saville A.W.
        • Albertin C.
        • et al.
        Parental hesitancy about routine childhood and influenza vaccinations: a national survey.
        Pediatrics. 2020; 146
        • Centers for Disease Control and Prevention
        Influenza Historic Timeline.
        (Available at) (Accessed on May 31, 2022)
        • Schmid P.
        • Rauber D.
        • Betsch C.
        • et al.
        Barriers of Influenza Vaccination Intention and Behavior - A Systematic Review of Influenza Vaccine Hesitancy, 2005 - 2016.
        PLoS One. 2017; 12: e0170550
        • Rolfes M.A.
        • Flannery B.
        • Chung J.R.
        • et al.
        Effects of Influenza Vaccination in the United States During the 2017-2018 Influenza Season.
        Clin Infect Dis. 2019; 69: 1845-1853
        • Grohskopf L.A.
        • Alyanak E.
        • Ferdinands J.M.
        • et al.
        Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2021-22 Influenza Season.
        MMWR Recomm Rep. 2021; 70: 1-28
        • Centers for Disease Control and Prevention
        Flu Vaccination Coverage, United States, 2020–21 Influenza Season.
        (Available at) (Accessed on April 14, 2022)
        • Centers for Disease Control and Prevention
        Weekly Flu Vaccination Dashboard.
        (Available at) (Accessed on July 24, 2022)
        • Opel D.J.
        • Mangione-Smith R.
        • Taylor J.A.
        • et al.
        Development of a survey to identify vaccine-hesitant parents: the parent attitudes about childhood vaccines survey.
        Hum Vaccin. 2011; 7: 419-425
        • Opel D.J.
        • Taylor J.A.
        • Mangione-Smith R.
        • et al.
        Validity and reliability of a survey to identify vaccine-hesitant parents.
        Vaccine. 2011; 29: 6598-6605
        • Opel D.J.
        • Taylor J.A.
        • Zhou C.
        • et al.
        The relationship between parent attitudes about childhood vaccines survey scores and future child immunization status: a validation study.
        JAMA Pediatr. 2013; 167: 1065-1071
        • Abd Halim H.
        • Abdul-Razak S.
        • Md Yasin M.
        • et al.
        Validation study of the Parent Attitudes About Childhood Vaccines (PACV) questionnaire: the Malay version.
        Hum Vaccin Immunother. 2020; 16: 1040-1049
        • Alsuwaidi A.R.
        • Elbarazi I.
        • Al-Hamad S.
        • et al.
        Vaccine hesitancy and its determinants among Arab parents: a cross-sectional survey in the United Arab Emirates.
        Hum Vaccin Immunother. 2020; 16: 3163-3169
        • Cunningham R.M.
        • Kerr G.B.
        • Orobio J.
        • et al.
        Development of a Spanish version of the parent attitudes about childhood vaccines survey.
        Hum Vaccin Immunother. 2019; 15: 1106-1110
        • Oladejo O.
        • Allen K.
        • Amin A.
        • et al.
        Comparative analysis of the Parent Attitudes about Childhood Vaccines (PACV) short scale and the five categories of vaccine acceptance identified by Gust et al.
        Vaccine. 2016; 34: 4964-4968
        • Olarewaju V.O.
        • Jafflin K.
        • Deml M.J.
        • et al.
        Application of the Parent Attitudes about Childhood Vaccines (PACV) survey in three national languages in Switzerland: Exploratory factor analysis and Mokken scale analysis.
        Hum Vaccin Immunother. 2021; 17: 2652-2660
        • Opel D.J.
        • Henrikson N.
        • Lepere K.
        • et al.
        Previsit screening for parental vaccine hesitancy: a cluster randomized trial.
        Pediatrics. 2019; 144
        • Hofstetter A.M.
        • Opel D.J.
        • Stockwell M.S.
        • et al.
        Influenza-related knowledge, beliefs, and experiences among caregivers of hospitalized children.
        Hosp Pediatr. 2021; 11: 815-832
        • Hofstetter A.M.
        • Simon T.D.
        • Lepere K.
        • et al.
        Parental vaccine hesitancy and declination of influenza vaccination among hospitalized children.
        Hosp Pediatr. 2018; 8: 628-635
        • Strelitz B.
        • Gritton J.
        • Klein E.J.
        • et al.
        Parental vaccine hesitancy and acceptance of seasonal influenza vaccine in the pediatric emergency department.
        Vaccine. 2015; 33: 1802-1807
        • Larson H.J.
        • Jarrett C.
        • Schulz W.S.
        • et al.
        Measuring vaccine hesitancy: The development of a survey tool.
        Vaccine. 2015; 33: 4165-4175
        • Shapiro G.K.
        • Tatar O.
        • Dube E.
        • et al.
        The vaccine hesitancy scale: Psychometric properties and validation.
        Vaccine. 2018; 36: 660-667
        • Domek G.J.
        • O'Leary S.T.
        • Bull S.
        • et al.
        Measuring vaccine hesitancy: Field testing the WHO SAGE Working Group on Vaccine Hesitancy survey tool in Guatemala.
        Vaccine. 2018; 36: 5273-5281
        • Gentile A.
        • Pacchiotti A.C.
        • Giglio N.
        • et al.
        Vaccine hesitancy in Argentina: Validation of WHO scale for parents.
        Vaccine. 2021; 39: 4611-4619
        • Helmkamp L.J.
        • Szilagyi P.G.
        • Zimet G.
        • et al.
        A validated modification of the vaccine hesitancy scale for childhood, influenza and HPV vaccines.
        Vaccine. 2021; 39: 1831-1839
        • Goldman R.D.
        • McGregor S.
        • Marneni S.R.
        • et al.
        Willingness to Vaccinate Children against Influenza after the Coronavirus Disease 2019 Pandemic.
        J Pediatr. 2021; 228: 87-93 e82
        • Sokol R.L.
        • Grummon A.H.
        COVID-19 and Parent Intention to Vaccinate Their Children Against Influenza.
        Pediatrics. 2020; 146
        • Estrada L.D.
        • Schultz-Cherry S.
        Development of a Universal Influenza Vaccine.
        J Immunol. 2019; 202: 392-398
        • Brewer N.T.
        What Works to Increase Vaccination Uptake.
        Acad Pediatr. 2021; 21: S9-S16
        • Malosh R.
        • Ohmit S.E.
        • Petrie J.G.
        • et al.
        Factors associated with influenza vaccine receipt in community dwelling adults and their children.
        Vaccine. 2014; 32: 1841-1847
        • Flood E.M.
        • Rousculp M.D.
        • Ryan K.J.
        • et al.
        Parents' decision-making regarding vaccinating their children against influenza: A web-based survey.
        Clin Ther. 2010; 32: 1448-1467
        • Allison M.A.
        • Reyes M.
        • Young P.
        • et al.
        Parental attitudes about influenza immunization and school-based immunization for school-aged children.
        Pediatr Infect Dis J. 2010; 29: 751-755
        • Hofstetter A.M.
        • Barrett A.
        • Stockwell M.S.
        Factors impacting influenza vaccination of urban low-income Latino children under nine years requiring two doses in the 2010-2011 season.
        J Community Health. 2015; 40: 227-234
        • Centers for Disease Control and Prevention
        Misconceptions about Seasonal Flu and Flu Vaccines.
        (Available at) (Accessed on June 3, 2022)
        • Centers for Disease Control and Prevention
        Vaccine Effectiveness: How Well Do Flu Vaccines Work?.
        (Available at) (Accessed on May 4, 2022)
        • Ferdinands J.M.
        • Olsho L.E.
        • Agan A.A.
        • et al.
        Effectiveness of influenza vaccine against life-threatening RT-PCR-confirmed influenza illness in US children, 2010-2012.
        J Infect Dis. 2014; 210: 674-683
        • Flannery B.
        • Reynolds S.B.
        • Blanton L.
        • et al.
        Influenza vaccine effectiveness against pediatric deaths: 2010-2014.
        Pediatrics. 2017; 139
        • Grant V.J.
        • Le Saux N.
        • Plint A.C.
        • et al.
        Factors influencing childhood influenza immunization.
        CMAJ. 2003; 168: 39-41
        • Chung J.R.
        • Flannery B.
        • Gaglani M.
        • et al.
        Patterns of Influenza Vaccination and Vaccine Effectiveness Among Young US Children Who Receive Outpatient Care for Acute Respiratory Tract Illness.
        JAMA Pediatr. 2020; 174: 705-713
        • Lin C.J.
        • Zimmerman R.K.
        • Nowalk M.P.
        • et al.
        Parental perspectives on influenza vaccination of children with chronic medical conditions.
        J Natl Med Assoc. 2006; 98: 148-153
        • Goss M.D.
        • Temte J.L.
        • Barlow S.
        • et al.
        An assessment of parental knowledge, attitudes, and beliefs regarding influenza vaccination.
        Vaccine. 2020; 38: 1565-1571
        • Daley M.F.
        • Crane L.A.
        • Chandramouli V.
        • et al.
        Influenza among healthy young children: changes in parental attitudes and predictors of immunization during the 2003 to 2004 influenza season.
        Pediatrics. 2006; 117: e268-e277
        • Nowalk M.P.
        • Lin C.J.
        • Zimmerman R.K.
        • et al.
        Tailored interventions to introduce influenza vaccination among 6- to 23-month-old children at inner-city health centers.
        Am J Manag Care. 2005; 11: 717-724
        • Hofstetter A.M.
        • Opel D.J.
        • Stockwell M.S.
        • et al.
        Associations between health care professional communication practices and influenza vaccination of hospitalized children.
        Acad Pediatr. 2021; 21: 1142-1150
        • Bhat-Schelbert K.
        • Lin C.J.
        • Matambanadzo A.
        • et al.
        Barriers to and facilitators of child influenza vaccine - perspectives from parents, teens, marketing and healthcare professionals.
        Vaccine. 2012; 30: 2448-2452
        • Green H.K.
        • Andrews N.
        • Letley L.
        • et al.
        Phased introduction of a universal childhood influenza vaccination programme in England: population-level factors predicting variation in national uptake during the first year, 2013/14.
        Vaccine. 2015; 33: 2620-2628
        • Bhatt P.
        • Block S.L.
        • Toback S.L.
        • et al.
        Timing of the availability and administration of influenza vaccine through the vaccines for children program.
        Pediatr Infect Dis J. 2011; 30: 100-106
        • Verani J.R.
        • Irigoyen M.
        • Chen S.
        • et al.
        Influenza vaccine coverage and missed opportunities among inner-city children aged 6 to 23 months: 2000-2005.
        Pediatrics. 2007; 119: e580-e586
        • Dombkowski K.J.
        • Davis M.M.
        • Cohn L.M.
        • et al.
        Effect of missed opportunities on influenza vaccination rates among children with asthma.
        Arch Pediatr Adolesc Med. 2006; 160: 966-971
        • Yoo B.K.
        • Szilagyi P.G.
        • Schaffer S.J.
        • et al.
        Cost of universal influenza vaccination of children in pediatric practices.
        Pediatrics. 2009; 124: S499-S506
        • Stockwell M.S.
        • Irigoyen M.
        • Andres Martinez R.
        • et al.
        Failure to return: parental, practice, and social factors affecting missed immunization visits for urban children.
        Clin Pediatr (Phila). 2014; 53: 420-427
        • Fiks A.G.
        • Nekrasova E.
        • Hambidge S.J.
        Health Systems as a Catalyst for Immunization Delivery.
        Acad Pediatr. 2021; 21: S40-S47
        • Stockwell M.S.
        • Stokley S.
        • Kempe A.
        Implementing Effective Vaccination Interventions Into Sustainable 'Real World' Practice.
        Acad Pediatr. 2021; 21: S78-S80
        • Stokley S.
        • Kempe A.
        • Stockwell M.S.
        • et al.
        Improving Pediatric Vaccination Coverage in the United States.
        Acad Pediatr. 2021; 21: S1-S2
        • Hofstetter A.M.
        • Robinson J.D.
        • Lepere K.
        • et al.
        Clinician-parent discussions about influenza vaccination of children and their association with vaccine acceptance.
        Vaccine. 2017; 35: 2709-2715
        • Orenstein E.W.
        • ElSayed-Ali O.
        • Kandaswamy S.
        • et al.
        Evaluation of a Clinical Decision Support Strategy to Increase Seasonal Influenza Vaccination Among Hospitalized Children Before Inpatient Discharge.
        JAMA Netw Open. 2021; 4: e2117809
        • Dempsey A.F.
        • Pyrznawoski J.
        • Lockhart S.
        • et al.
        Effect of a Health Care Professional Communication Training Intervention on Adolescent Human Papillomavirus Vaccination: A Cluster Randomized Clinical Trial.
        JAMA Pediatr. 2018; 172: e180016
        • Labbe S.
        • Colmegna I.
        • Valerio V.
        • et al.
        Training Physicians in Motivational Communication to Address Influenza Vaccine Hesitation: A Proof-of-Concept Study.
        Vaccines (Basel). 2022; 10
        • Opel D.J.
        • Zhou C.
        • Robinson J.D.
        • et al.
        Impact of Childhood Vaccine Discussion Format Over Time on Immunization Status.
        Acad Pediatr. 2018; 18: 430-436
        • Fontenot H.B.
        • Kornides M.L.
        • McRee A.L.
        • et al.
        Importance of a team approach to recommending the human papillomavirus vaccination.
        J Am Assoc Nurse Pract. 2018; 30: 368-372
        • Real F.J.
        • DeBlasio D.
        • Beck A.F.
        • et al.
        A Virtual Reality Curriculum for Pediatric Residents Decreases Rates of Influenza Vaccine Refusal.
        Acad Pediatr. 2017; 17: 431-435
        • Nowak G.J.
        • Evans N.J.
        • Wojdynski B.W.
        • et al.
        Using immersive virtual reality to improve the beliefs and intentions of influenza vaccine avoidant 18-to-49-year-olds: Considerations, effects, and lessons learned.
        Vaccine. 2020; 38: 1225-1233
        • Bonnevie E.
        • Rosenberg S.D.
        • Kummeth C.
        • et al.
        Using social media influencers to increase knowledge and positive attitudes toward the flu vaccine.
        PLoS One. 2020; 15: e0240828
        • Ponce-Gonzalez I.M.
        • Perez K.
        • Cheadle A.D.
        • et al.
        A multicomponent health education campaign led by community health workers to increase influenza vaccination among migrants and refugees.
        J Prim Care Community Health. 2021; 12 (21501327211055627)
        • Huang J.A.-O.
        • Francesconi M.
        • Cooper M.H.
        • et al.
        Community health workers on a college campus: Effects on influenza vaccination.
        J Am Coll Health. 2018; 66: 317-323
        • Krupenkin M.
        • Yom-Tov E.A.-O.
        • Rothschild D.
        Vaccine advertising: preach to the converted or to the unaware?.
        NPJ Digit Med. 2021; 4: 23
        • Hadler J.L.
        • Yousey-Hindes K.
        • Kudish K.
        • et al.
        Impact of requiring influenza vaccination for children in licensed child care or preschool programs--Connecticut, 2012-13 influenza season.
        MMWR Morb Mortal Wkly Rep. 2014; 63: 181-185
      2. Influenza Vaccine Mandates for Child Care and Pre-K.
        (Available at) (Accessed on April 15, 2022)
        • Hong K.
        • Lindley M.C.
        • Tsai Y.
        • et al.
        School Mandate and Influenza Vaccine Uptake Among Prekindergartners in New York City, 2012-2019.
        Am J Public Health. 2022; 112: 719-723
        • Omer S.B.
        • Allen K.
        • Chang D.H.
        • et al.
        Exemptions From Mandatory Immunization After Legally Mandated Parental Counseling.
        Pediatrics. 2018; 141
        • Stockwell M.S.
        • Kharbanda E.O.
        • Martinez R.A.
        • et al.
        Effect of a text messaging intervention on influenza vaccination in an urban, low-income pediatric and adolescent population: a randomized controlled trial.
        JAMA. 2012; 307: 1702-1708
        • Stockwell M.S.
        • Hofstetter A.M.
        • DuRivage N.
        • et al.
        Text message reminders for second dose of influenza vaccine: a randomized controlled trial.
        Pediatrics. 2015; 135: e83-e91
        • Hofstetter A.M.
        • Vargas C.Y.
        • Camargo S.
        • et al.
        Impacting delayed pediatric influenza vaccination: a randomized controlled trial of text message reminders.
        Am J Prev Med. 2015; 48: 392-401
        • Hofstetter A.M.
        • Barrett A.
        • Camargo S.
        • et al.
        Text message reminders for vaccination of adolescents with chronic medical conditions: A randomized clinical trial.
        Vaccine. 2017; 35: 4554-4560
        • Sloand E.
        • VanGraafeiland B.
        • Holm A.
        • et al.
        Text message quality improvement project for influenza vaccine in a low-resource largely latino pediatric population.
        J Healthc Qual. 2019; 41: 362-368
        • Jacobson Vann J.C.
        • Jacobson R.M.
        • Coyne-Beasley T.
        • et al.
        Patient reminder and recall interventions to improve immunization rates.
        Cochrane Database Syst Rev. 2018; 1: CD003941
        • Szilagyi P.G.
        • Albertin C.S.
        • Saville A.W.
        • et al.
        Effect of state immunization information system based reminder/recall for influenza vaccinations: a randomized trial of autodialer, text, and mailed messages.
        J Pediatr. 2020; 221: 123-131 e124
        • Kempe A.
        • Saville A.W.
        • Albertin C.
        • et al.
        Centralized reminder/recall to increase influenza vaccination rates: a two-state pragmatic randomized trial.
        Acad Pediatr. 2020; 20: 374-383
        • Lerner C.
        • Albertin C.
        • Casillas A.
        • et al.
        Patient portal reminders for pediatric influenza vaccinations: a randomized clinical trial.
        Pediatrics. 2021; 148
        • Milkman K.L.
        • Patel M.S.
        • Gandhi L.
        • et al.
        A megastudy of text-based nudges encouraging patients to get vaccinated at an upcoming doctor's appointment.
        Proc Natl Acad Sci U S A. 2021; 118
        • Buttenheim A.
        • Milkman K.L.
        • Duckworth A.L.
        • et al.
        Effects of ownership text message wording and reminders on receipt of an influenza vaccination: a randomized clinical trial.
        JAMA Netw Open. 2022; 5: e2143388
        • Szilagyi P.G.
        • Albertin C.S.
        • Casillas A.
        • et al.
        Effect of Personalized Messages Sent by a Health System's Patient Portal on Influenza Vaccination Rates: a Randomized Clinical Trial.
        J Gen Intern Med. 2022; 37: 615-623
        • Lee W.-N.
        • Stück D.
        • Konty K.
        • et al.
        Large-scale influenza vaccination promotion on a mobile app platform: A randomized controlled trial.
        Vaccine. 2020; 38: 3508-3514
        • Salmon D.A.
        • Limaye R.J.
        • Dudley M.Z.
        • et al.
        MomsTalkShots: An individually tailored educational application for maternal and infant vaccines.
        Vaccine. 2019; 37: 6478-6485
        • Dale L.P.
        • White L.
        • Mitchell M.
        • et al.
        Smartphone app uses loyalty point incentives and push notifications to encourage influenza vaccine uptake.
        Vaccine. 2019; 37: 4594-4600
        • Stockwell M.S.
        • Catallozzi M.
        • Camargo S.
        • et al.
        Registry-linked electronic influenza vaccine provider reminders: a cluster-crossover trial.
        Pediatrics. 2015; 135: e75-e82
        • Fiks A.G.
        • Grundmeier R.W.
        • Biggs L.M.
        • et al.
        Impact of clinical alerts within an electronic health record on routine childhood immunization in an urban pediatric population.
        Pediatrics. 2007; 120: 707-714
        • Au L.
        • Oster A.
        • Yeh G.H.
        • et al.
        Utilizing an electronic health record system to improve vaccination coverage in children.
        Appl Clin Inform. 2010; 1: 221-231
        • Committee On Infectious Diseases
        Recommendations for prevention and control of influenza in children, 2021-2022.
        Pediatrics. 2021; 148 (e2021053745)
        • Hofstetter A.M.
        • Schaffer S.
        Childhood and adolescent vaccination in alternative settings.
        Acad Pediatr. 2021; 21: S50-S56
        • Beatty N.L.
        • Hager K.M.
        • McKeown K.R.
        • et al.
        Influenza vaccine availability at urgent care centers in the state of Arizona.
        Am J Infect Control. 2018; 46: 946-948
        • Kempe A.
        • Wortley P.
        • O'Leary S.
        • et al.
        Pediatricians' attitudes about collaborations with other community vaccinators in the delivery of seasonal influenza vaccine.
        Acad Pediatr. 2012; 12: 26-35
        • Benjamin-Chung J.
        • Arnold B.F.
        • Kennedy C.J.
        • et al.
        Evaluation of a city-wide school-located influenza vaccination program in Oakland, California, with respect to vaccination coverage, school absences, and laboratory-confirmed influenza: A matched cohort study.
        Plos Med. 2020; 17: e1003238
        • Pannaraj P.S.
        • Wang H.-L.
        • Rivas H.
        • et al.
        School-located influenza vaccination decreases laboratory-confirmed influenza and improves school attendance.
        Clin Infect. 2014; 59: 325-332
        • Szilagyi P.A.-O.
        • Schaffer S.
        • Rand C.M.
        • et al.
        School-Located Influenza Vaccination: Do Vaccine Clinics at School Raise Vaccination Rates?.
        J Sch Health. 2019; 89: 1004-1012
        • Tran C.H.
        • Sugimoto J.D.
        • Pulliam J.R.C.
        • et al.
        School-located influenza vaccination reduces community risk for influenza and influenza-like illness emergency care visits.
        PLoS One. 2014; 9: e114479
        • Szilagyi P.G.
        • Schaffer S.
        • Rand C.M.
        • et al.
        School-Located Influenza Vaccinations: A Randomized Trial.
        Pediatrics. 2016; 138
        • Schmit C.D.
        • Penn M.S.
        Expanding state laws and a growing role for pharmacists in vaccination services.
        J Am Pharm Assoc (2003). 2017; 57: 661-669
        • Robison S.G.
        Impact of pharmacists providing immunizations on adolescent influenza immunization.
        J Am Pharm Assoc (2003). 2016; 56: 446-449
        • Mosesso Jr., V.N.
        • Packer R.
        • McMahon J.
        • et al.
        Influenze immunizations provided by EMS agencies: The MEDICVAX project.
        Prehosp Emerg Care. 2003; 7: 74
        • Centers for Disease Control and Prevention
        Progress in immunization information systems - United States, 2012.
        MMWR Morb Mortal Wkly Rep. 2013; 62: 1005-1008
        • Birmingham E.
        • Catallozzi M.
        • Findley S.E.
        • et al.
        FluAlert: a qualitative evaluation of providers' desired characteristics and concerns regarding computerized influenza vaccination alerts.
        Prev Med. 2011; 52: 274-277
        • Stockwell M.S.
        • Natarajan K.
        • Ramakrishnan R.
        • et al.
        Immunization data exchange with electronic health records.
        Pediatrics. 2016; 137
        • Hughes M.M.
        • Reed C.
        • Flannery B.
        • et al.
        Projected population benefit of increased effectiveness and coverage of influenza vaccination on influenza burden in the United States.
        Clin Infect Dis. 2020; 70: 2496-2502