In the United States certain vaccines are supposed to be administered to inpatients who meet specific criteria. Sometimes the vaccination rate can be disappointingly low.

Rationale for inpatient vaccination:

(1) The patient is available.

(2) The patient may be more vulnerable to infection.


Targeted vaccinations may include pneumococcal and influenza vaccines.


Barriers to vaccination:

(1) patient transfer

(2) rapid or unexpected discharge

(3) discharge outside of usual hours (with less staffing) or when extremely busy

(4) poor medical records or communication with physician’s office

(5) poor or inconsistent documentation of vaccination status

(6) no or minimal monitoring and feedback on the performance of the vaccination program

(7) limited access to vaccine on ward, including vaccine shortage

(8) failure to order the vaccination

(9) failure to administer an ordered vaccines

(10) patient declination

(11) indications unclear


Ways to improve vaccination rates:

(1) standing order

(2) physician and nurse reminders, chart or computer-based

(3) incorporation into the discharge process

(4) prioritizing inpatient vaccination

(5) patient education

(6) improved tracking

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