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CPT John D. Grabenstein, MS, RPh, USA; Laurie J. Smith, MD; Doris W. Carter, RN; MAJ Renata J. Engler, MC, USA; COL Richard Evans III, MC, USA; COL Richard J. Summers, MC, USA

Arch Intern Med. 1986;146(6):1189-1192.

Abstract
• All patients and employees presenting for influenza A and B vaccination were studied for the need for other immunizations or tests, based on criteria of the Immunization Practices Advisory Committee. More than 72% of patients and employees needed at least one other vaccine or test. During a 4-month period, 1,353 doses of influenza virus vaccine, bivalent, types A and B, were prescribed. Health care providers ordered doses of diphtheria and tetanus toxoids (adult) for 36.8% of these recipients, pneumococcal vaccine, polyvalent 23, for 42.1%, and a tuberculin skin test for 36.3%. Determinations of hepatitis B titers or hepatitis B vaccine doses were ordered for 140 individuals. Patients older than 60 years needed additional immunizations with greater frequency. Rates of delayed adverse reactions (35.9%) and subsequent self-medication (11.7%) were recorded. The systemic adverse reaction rate was 17.3%. Annual influenza vaccination programs are valuable public health opportunities to determine immunizations needed

Author Affiliations
From the Allergy—Clinical Immunology Service, Walter Reed Army Medical Center, Washington, DC.

Footnotes
Accepted for publication Oct 10, 1985.

Presented in part as a scientific exhibition at the 41st Congress of the American College of Allergists, Bal Harbour, Fla, Feb 3, 1985.

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

Reprint requests to Allergy—Clinical Immunology Service, Walter Reed Army Medical Center, Washington, DC 20307-5001 (Mr Grabenstein).

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