Influenza vaccine delivery models in secondary care (hospital) settings: What approaches are used to enhance access for clinical risk groups in England?

Background: Influenza vaccine uptake rates in England remain suboptimal among adults with clinical conditions that predispose to severe influenza. Influenza vaccines are predominantly delivered in primary care settings, but complementary delivery via a broader range of secondary care settings is recommended to enhance access. This qualitative study aimed to document current influenza vaccine delivery models in hospital-based settings and to compare the opportunities and limitations associated with those delivery models. Methods: Semi-structured interviews (n = 28) were conducted with healthcare professionals based in secondary care, and with National Health Service commissioners to understand current vaccine delivery practices within hospital settings in two regions of England. Results: Most hospitals who offered patient vaccination had invested in dedicated staff and processes to support influenza vaccine delivery. A variety of interventions were used to navigate the steps in the vaccination pathway. Challenges included engagement of medical staff, access to vaccination records and managing vaccine stocks. Conclusion: Secondary care vaccination is possible with the appropriate investment in staff and processes. Focusing on staff engagement, addressing logistic challenges and providing adequate invesment would support the sustainability of vaccination in secondary care.