Evaluation of an authorized nurse immunizer led opportunistic patient influenza and COVID-19 vaccination program under the RE-AIM framework

Abstract

Influenza and COVID-19 are significant vaccine-preventable causes of morbidity, mortality, and healthcare costs. Hospital-based, nurse-led models can increase vaccine uptake, yet few target adults. This study evaluates the implementation of an opportunistic patient influenza and COVID-19 vaccination program in the Central Coast Local Health District (CCLHD), led by Authorized Nurse Immunizers (ANIs). Evaluation of the ANI-led program was conducted using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. The 10-week program involved screening patients for vaccine eligibility, offering vaccinations and collecting quantitative data and qualitative feedback across the five RE-AIM domains. Of 849 patients screened alongside service encounters, 398 were vaccinated with 76% of eligible patients consenting to flu and 59% to COVID-19 vaccination. Inpatients had lower vaccination rates on admission compared to the general population and higher rates after program contact. The program was well received by patients and staff and adopted across various CCLHD settings, effectively addressing community access barriers. Opportunistic vaccination using an ANI-led model is an effective strategy to improve vaccination coverage among higher-risk patients. This evaluation demonstrates the benefits of a dedicated nurse immunizer workforce and suggests potential for broader adoption in similar healthcare settings to improve public health outcomes.