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Influenza – Boosting vaccination rates for high-risk patients

Annual influenza vaccination is the best way to prevent severe illness, hospitalisation and death due to influenza. In 2024, influenza accounted for 29% of recorded notifiable diseases.1 Influenza remains the most common cause of hospitalisation for notifiable diseases over the past decade.2

Influenza can be risky for children, particularly those under 5 years of age, who have an increased risk of hospitalisation and morbidity.2 Despite this, only 22% of children in Queensland aged 6 months to 5 years received an influenza vaccine in 2024.3 Young children aren’t the only population at increased risk; pregnant women, people over 65, Aboriginal and Torres Strait Islander peoples and people with chronic conditions are also more likely to have severe complications from influenza.2

Across Queensland and most age groups, influenza vaccination uptake has continued to decline whilst cases have increased:3,4,5

YearVaccine coverage (%)Total number of cases
202236%45,311
202333%74,355
202429%79,197


Queensland will continue the subsidised flu program for 2025: Between March 1st and September 2025, all Queenslanders over six months old are eligible for a free influenza vaccination.   

These data trends suggest that cost alone is not attributable to declining rates4 and that strategies to target vaccine fatigue and hesitancy, especially in priority populations, are needed. General practice teams play a pivotal role in safeguarding the community against influenza by providing education, promoting proactive vaccination, and facilitating influenza treatment.

This QI activity focuses on how to identify and engage your practice population to increase influenza vaccination coverage.

This QI Toolkit relates to the following PIPQI Quality Improvement Measures (QIMs):

  1. QIM #4: Proportion of regular clients aged 65 years and over with an influenza immunisation status recorded in their GP record within the previous 15 months.
  2. QIM #5: Proportion of regular clients with diabetes with an influenza immunisation status recorded in their GP record within the previous 15 months.
  3. QIM #6: Proportion of regular clients with COPD with an influenza immunisation status recorded in their GP record within the previous 15 months.

QIM #4: Influenza vax recorded (aged 65+)

As of July 2024, the CCQ region reported 55.1% of regular clients aged 65 years and over had an influenza immunisation status recorded in their GP record in the previous 15 months, lower than the 56.7% across Queensland and 55.9% nationally. 

Click image to enlarge.
Source: AIHW (accessed April 2025)

QIM #5: Influenza vax recorded (diabetes)

As of July 2024, the CCQ region reported 50.6% of regular clients with diabetes had an influenza immunisation status recorded in their GP record within the previous 15 months, higher than the 49.7% across Queensland and 48.4% nationally. 

Click image to enlarge.
Source: AIHW (accessed April 2025)

QIM #6: COPD (recorded flu vax)

As of July 2024, the CCQ region reported 57.7% of regular clients aged 15 years and over with a COPD diagnosis had an influenza immunisation status recorded in their GP record within the previous 15 months in the CCQ region, lower than the 58.2% across Queensland 58.4% nationally. 

Click image to enlarge.
Source: AIHW (accessed April 2025)

Increase influenza vaccination coverage within the practice population.

To achieve this goal, you can access a range of resources:

Review current best practices:

  1. The Australian Government Department of Health, Disability and Ageing provides a range of resources, including up-to-date immunisation guidelines and patient resources.
  2. Australian Immunisation Handbook provides clinical advice for health professionals on the safest and most effective use of vaccines.
  3. NCIRS provides influenza immunisation resources and data to assist healthcare providers and the general public.
  4. HealthPathways: Explore locally tailored approaches. Simply enter “Influenza Immunisation” in the search bar to get started.

Kickstart your quality improvement activity by bringing together a quality improvement team. Together, you’ll identify the key challenges and come up with innovative solutions, ensuring you all share a clear understanding of the improvement objectives and strategies.

  1. Engage with your Primary Health Coordinator from CCQ; they can offer tailored support, resources and guidance to enhance your QI efforts wherever you are in your QI journey. Your Primary Health Coordinator can support your practice to:
    • Bring a QI team together to decide on an improvement idea
    • Plan, start and finish a QI activity
    • Facilitate QI meetings
    • Create practice-wide systems improvement
  1. Gather data and information. Review current practice data and processes for influenza vaccination.
  2. Identify and discuss any common enablers and barriers to optimal influenza vaccination. Consider using process maps, flow charts or driver diagrams to generate change ideas and improve processes.

What data might you need? You’ll need data to understand the problem and measure your outcomes. We suggest you start with:

  1. Primary Sense can provide insight, detailed reports and targeted guidance on improving data quality, specifically in relation to influenza vaccination.The following reports are available within Primary Sense:
    • Winter Wellness: Identifies vulnerable patients aged 5-59 years old who may be eligible for seasonal vaccinations, including fluvax, pneumovax and COVID vaccination status.
    • Pregnant and Vaccinations: Identifies pregnant women without a record of vaccination for pertussis and/or influenza during the current pregnancy.
    • There are two disease-specific reports that identify vaccination status for the respective patient cohorts with a coded diagnosis: Chronic Lung Disease and Asthma Report and Diabetes Mellitus Report.
  2. Australia Immunisation Registrar (AIR): the AIR allows you to record immunisations given elsewhere into your practice clinical software. Before starting your QI, ensure the AIR is integrated with your practice software and, if necessary, manually update individual patient results from the AIR in your practice software.

To achieve your goal, you can consider several improvement ideas such as:

  1. Utilise the Primary Sense report “Winter Wellness” and add a reminder and/or vaccination recall to eligible patient records to maximise opportunistic immunisation appointments.
  2. Create a weekly children’s influenza vaccination clinic during the months of April and May. Promoting the clinic could include posters, SMS reminders and opportunistic discussion during other routine childhood vaccination bookings.
  3. Utilise the Primary Sense report “Winter Wellness” and flag patients with an existing appointment to see the practice nurse prior to the GP to discuss benefits and identify any barriers to vaccination.
  4. Utilise the Primary Sense prompt “Due influenza vaccination – check COVID vax” to provide opportunistic vaccination.
  5. Utilise specific Primary Sense reports, such as Diabetes Mellitus, to prioritise and increase influenza vaccination coverage in high-risk patients. Or consider utilising the Primary Sense report “Child Immunisations” to align opportunistic influenza vaccination discussion with other routine childhood vaccinations.

Remember to self-report your QI project as a CPD activity. QI is a great tool for measuring tangible outcomes and demonstrating improvement in patient care!

Share your results with your CCQ practice support team and with your patients. Ensure you document your quality improvement activity to meet PIP QI guidelines and for CPD purposes.

References

  1. National Notifiable Disease Surveillance System, National Communicable Disease Surveillance Dashboard, available at: https://nindss.health.gov.au/pbi-dashboard, extracted 16 January 2025.
  2. Australia Institute of Health and Welfare (2024) Infectious and communicable diseases, AIHW, Australia Government, accessed 7 January 2025.
  3. National Centre for Immunisation Research and Surveillance Australia (2024) Influenza vaccination coverage, NCISRS, accessed 7 January 2025.
  4. NewsGP (2025) Queensland extends free flu vaccination program, RACGP, accessed 7 January 2025.
  5. Queensland Health, Acute respiratory infection surveillance reporting, Queensland Government, available at: https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/diseases-infection/surveillance/reports/flu, accessed 16 January 2025.
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Aboriginal and Torres Strait IslandersCCQ acknowledges the Traditional Custodians of the land on which we work and live, and recognises their continuing connection to land, waters and community. We pay our respect to them and their cultures; and to Elders past, present and emerging.

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