Improving Vaccination Rates among Breast Cancer Patients Through Patient Outreach

Abstract

Problem: Cancer patients are high risk for morbidity and mortality from infection, which can be reduced through vaccination. In 2021, vaccination rates were low at an academic medical center breast clinic at a 62.5% pneumococcal, 18% influenza, and 24% shingles rate. Purpose: The purpose of this quality improvement (QI) project was to implement and evaluate a patient outreach and education intervention to increase influenza, shingles, and pneumococcal vaccination in eligible breast cancer patients. Methods: The “4 Pillars Practice Transformation Program” was used. The oncology nurse navigator (ONN) assessed and documented vaccination history in the electronic medical record. The ONN discussed vaccination recommendations with the provider and recommended concurrent vaccinations. Within a two-week period, the ONN reassessed vaccination status, provided reminders, and documented follow up. Implementation occurred over a 16-week period. Results: All measurements improved from baseline and compared to 2021 rates. Vaccine follow up increased from 0% to 92.3% with a median rate of 92.9%. Influenza vaccine documentation increased from 0% to 88.5% with a median of 75%. Pneumococcal vaccine documentation increased from 0% to 70.8% with a median of 54.4%. Shingles vaccine documentation increased from 0% to 58.3% with a median of 50%. Conclusion: An education and outreach program using the “4 Pillars Practice Transformation Program” can increase breast cancer patients’ vaccination rates, which is important in this population. A successful program must include staff accountability for individualized outreach, considering patient’s age, vaccine history, and risk factors. Barriers noted include delayed patient vaccine administration reporting and community pharmacist vaccine knowledge for the oncology population. Next steps include sustaining intervention and adapting for use at other clinics.