Abstract
Background: Vaccines are an integral part of medicine and public health today responsible for decreasing the incidence, prevalence, morbidity, and mortality of vaccine-preventable diseases (Ventola, 2016). Despite the ACIP recommendations, adults are often inadequately vaccinated. Some factors that influence low adult vaccination compliance include low priority, lack of information, fear or opposition to vaccines, cost, accessibility, and operational or systemic barriers (Ventola, 2016).|Problem: The clinical problem present in the adult primary care setting today is low compliance for recommended adult immunization.|Purpose: The purpose of this project is to improve education on the importance of the Shingrix vaccine series and identify patients eligible for the Shingrix vaccine series. Provider education will be provided to ensure awareness and provide discussion points with eligible patients.|Methods: First, healthcare providers at Mercy Clinic Des Peres will receive an educational in service and distribution of a pre-survey to identify current knowledge regarding herpes zoster and Shingrix vaccine series. In addition, patients identified who are eligible will receive an educational summary on their After Visit Summary (AVS) explaining why they should receive the Shingrix vaccine series and where they can receive the vaccine. Follow up phone calls and EMR chart reviews will be completed to assess if they received the vaccine or identify barriers to receiving the vaccine. Finally, statistical analysis will be completed on the frequency of the Shingrix vaccine series administration after the education intervention, in addition to identification of barriers to vaccine administration.|Results: Prior to the educational intervention, Mercy Clinic Internal Medicine Des Peres was below the national average of Shingrix immunization rate of 34.5% in 2018. After the educational intervention for providers and patients, an increase in first dose immunization administration from August to December 2021 was found to be 0.9% of patients in the practice receiving a first dose, and 0.7% of patients receiving a second dose.|Conclusion: A survey of providers was conducted prior to project implementation to identify barriers to immunization in the clinic setting. Barriers to immunization during the completion of the quality improvement project included timing of COVID-19 vaccination and booster doses, influenza vaccination administration, availability of immunization series in the clinic setting and health literacy. An increase in first dose administration by 0.9% and second dose administration by 0.7% was observed as a result of the educational intervention. Better sustainability could be achieved with automated phone calls or text message system management. Limitations to the quality improvement project included indicating casualty as well as the recommended interval between first and second dose administration being two to six months while the project was implemented over 5 months.