Best Practices for Scheduling Influenza Vaccines in Your Practice

Run a report for all children in your practice with any asthma diagnosis, diabetes diagnosis, and other chronic conditions or illnesses for the past two years.
Prioritize these children for vaccination upon receipt of your influenza vaccine inventory as these are the children at higher risk for complications due to influenza infection. Review table 2 of the policy statement for individuals at high risk of influenza complications.

Run a separate report of all other active patients.
Excluding patients scheduled for well-child exams in the months of August, September, and October from the report will help lighten the recall process. Patients scheduled for well-child exams should receive their influenza vaccine during that visit.

Identify children who are due for other routine childhood immunizations. Communicate this with patients and parents/caregivers to schedule vaccination appointments. Use every opportunity to catch up on missed immunizations.

• When you are ready to start administering influenza vaccine, inform your patients by posting signs in the waiting areas and exam rooms, sending out reminder flyers via email/text (must have email/text waiver signed by parent/patient), and posting updates on the practice's web and social media sites.
• The AAP Flu Toolkit offers videos, graphics, photos, sample social media posts and other communications tools to help you share messages promoting the influenza vaccine. Including influenza vaccine reminder graphics and editable flyers to promote an influenza vaccination clinic.

Advise your physicians, nurses, front desk staff, and anyone who will have contact with patients/families that influenza vaccine is in stock and to either offer vaccine to those in the office or schedule appointments for those who call. Influenza vaccine should be offered to patients/families at any visit (not just well visits), after first ensuring there is not a contraindication or precaution present.

Train those who answer the office phones to tell patients/families who call (whether to ask a question or to schedule any type of appointment), that influenza vaccines are available and offer to schedule a vaccination appointment.

Train all staff to promote vaccination and communicate vaccine benefits to patients and families. Consider developing a script or talking points for the front desk and scheduling staff to use when speaking with patients and families.

Use key messages when communicating with patients and parents/caregivers the importance and benefits of influenza vaccine. See AAP resource on Communicating with Families and Promoting Vaccine Confidence.

Physicians and nurses should offer vaccine to siblings who are patients and who may be in the office, whether they are scheduled for an appointment or not. Clinics should be flexible, when necessary, to meet the needs of patients. "Never miss an opportunity" to vaccinate should always be the office mantra, especially once the influenza vaccine has been delivered.

Administering vaccination to parents and caregivers at pediatric practices will provide protection to the adult family contacts, which is especially important for all family members who are at high risk for influenza disease (ie, health status, ineligible to be vaccinated). For more information, refer to the Immunizing Parents and Other Close Family Contacts in the Pediatric Office Setting technical report.

• Make special accommodations for children and youth with special health care needs. Identify patients who will need special accommodations and establish a plan for the specific patient and their needs before they arrive.
• Encourage families to bring comfort items to the vaccine appointment.
• Consider dedicating certain spaces as low sensory environments for children with a variety of diagnoses who may benefit. Specific clinic spaces, dates and times can be set aside for those with special sensory needs.

The message can simply advise parents that the influenza vaccine is in stock, and they should call at their earliest convenience to schedule their child's influenza vaccination.

Follow recommended practices for the use of PPE when vaccinating, just as for all encounters. Standard precautions should be used at all times and in all situations in health care. Additionally, infection prevention and control practices should be utilized based on anticipated exposures and suspected or confirmed diagnoses.

• Vaccine-only appointments should be shorter in length and should be offered during a variety of times, including outside of school and work hours. Plan vaccine-only appointments when you have extra staff or on traditionally slower days.
• Having a separate schedule allows you to have sufficient staff and to keep track of vaccine supply.
  • Using a separate appointment type such as "flu vaccine" allows you to continually track how many patients still need appointments.
• One idea is to schedule patients for influenza vaccines anytime the office is open and assign a maximum number of appointments per day or half day. Otherwise, office staff could have more patients than they are able to manage.

This can allow a practice to vaccinate a much larger group of patients more efficiently and prior to the start of influenza virus circulation.

• Schedule patients for influenza vaccine early or late in the day (eg, if practice is open 8 am-5 pm, schedule between 7 am and 8 am or between 5 pm and 6 pm).
• Have flu clinics on Saturdays—this is helpful for children who need a second dose of influenza vaccine.
  • Saturday clinics eliminate crowding in the office once the high-volume fall season starts. It also keeps "well" kids from sitting in the waiting room with "sick" kids (if you do not have regularly scheduled office hours).
  • Designate a "flu clinic organizer" to do the prep work needed to make your influenza clinic run smoothly.

At the end of each month starting when your first shipment of vaccine is received, run a follow-up scheduling report of all active patients; excluding those scheduled for well-child exams through October and those already scheduled for an influenza vaccine appointment. These remaining patients may require extra outreach. A follow up call/text/mailing/email is likely necessary.

One way to ensure that children who need two doses are scheduled in a timely way is to schedule a second dose vaccine appointment at the time of the first dose. Offer a reminder card listing the appointment information before they leave the office.

• Influenza is unpredictable, may have multiple peaks, and can occur at any time. It is important to continue promoting and administering vaccines through June.
• Promote influenza vaccination to your patient population throughout the season with the goal of vaccinating all eligible patients.