A Quality Assurance (QA) Project on Flu Vaccinations in Queens Hospital Diabetes Clinic

A Quality Assurance (QA) Project on Flu Vaccinations in Queens Hospital Diabetes Clinic | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report A Quality Assurance (QA) Project on Flu Vaccinations in Queens Hospital Diabetes Clinic Veda Sabarinath, Isaac Sachmechi, MD, FACE, FACP This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8468430/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract The Diabetes Clinic at NYC HHC/Queens Hospital Center decided to conduct a Quality Assurance project aiming to gauge the patients’ perspective on the effectiveness, accessibility, and adverse effects of the flu vaccine. This survey was conducted from July to August 2024. The survey was administered via a confidential questionnaire in which patients were asked to fill out a series of questions assessing their knowledge, experience, side effects, accessibility, and willingness to take it in the future. The questionnaire was administered in both English and Spanish. Preventive Medicine Epidemiology Statistical Epidemiology Quality Assurance Project Flu Vaccine Diabetes NYC HHC Queens Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction The common flu, also known as Influenza, is a highly contagious respiratory illness caused by influenza viruses. It can lead to mild to severe illness and, in extreme cases, hospitalization or even death, although this is mostly seen in high-risk populations such as the elderly, young children, pregnant women, and those with chronic illnesses (Centers for Disease Control and Prevention, 2024 ). The flu is most commonly spread through droplets when an infected person coughs, sneezes, or talks, and it can cause symptoms such as fever, cough, sore throat, body aches, fatigue, and in severe cases, pneumonia or organ failure (Centers for Disease Control and Prevention, 2024 ). Every year, seasonal flu outbreaks affect millions of people worldwide, placing a significant strain on healthcare systems, especially during peak flu season. The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) emphasize the importance of influenza vaccination as the most effective way to prevent the flu and reduce its impact on public health (World Health Organization 2025 ). Vaccines are specifically designed to protect individuals from the flu strains predicted to be most prevalent this year (World Health Organization, 2025 ). Taking the flu vaccination has its implications for diabetic patients, especially. Patients with Type 2 Diabetes have an increased risk for a more severe course of influenza virus infection. There is increasing evidence that influenza vaccination in patients with diabetes can safely reduce all-cause mortality and cardiovascular death. From our point of view, it should be an integral part of treatment strategies in patients with diabetes (Verket et. al, 2023 ). Methods This survey was conducted using a questionnaire form, which was distributed to patients who came into the Diabetes Clinic for their appointments. The questionnaire had 12 questions and was administered in both English and Spanish. 25 patients were interviewed. Data was analyzed using Google Sheets, and graphs were generated using Quadratic. Results Data was collected from the patients using the responses from the questionnaire. Looking at patterns, trends, and correlations between categories, responses culminate in the following (See Figs. 1 – 5 ) This pie chart presents the percentage of surveyed patients who reported taking the flu vaccine compared to those who did not. This figure illustrates the patients’ knowledge about the flu as a serious disease. This figure displays the reported incidence of side effects among surveyed patients who took the flu vaccine. This pie chart shows the distribution of patient perceptions regarding the effectiveness of the flu vaccination. This bar graph illustrates the number of surveyed patients who cited barriers that prevented them from receiving the flu vaccination. Discussion The data collected provides insights into patient experiences. Of the 25 patients surveyed, 76% (19 patients) reported taking the flu vaccine, while 24% (6 patients) did not (Fig. 1 ). When assessing the surveyed patients’ knowledge regarding the flu, 14 of the 25 respondents believed the flu is considered a serious disease. At the same time, 9 out of 25 reported that they did not think it was a serious disease, and 2 patients had no response (Fig. 2 ). This data shows that most patients are aware of the seriousness of the flu and are well educated on this matter. Regarding side effects of the flu vaccination, 18 of the 25 respondents answered “No” to side effects, while 6 patients responded “Yes”(Fig. 3 ). Figure 4 illustrates patient perceptions of the vaccine's effectiveness. A substantial 72% of respondents said yes to the flu vaccine being effective, indicating a very high perceived effectiveness. On the other hand, only 28% of the sample population said no to the flu vaccine being effective. This overwhelmingly positive perception of effectiveness aligns with the hospital’s Diabetes clinic’s goal of 100% patient compliance for the flu vaccine and suggests that patients generally consider the flu vaccine to be highly effective. Lastly, several barriers to receiving the vaccine were surveyed, including transportation, health, religious, and financial difficulties. From these categories, 2 patients reported transportation, 3 reported health issues, and 1 patient for religious and financial difficulties (Fig. 5 ). Out of the 6 patients who didn’t take the flu shot this year(24% of total sample size), only 2 cited barriers as to why they couldn’t take the flu shot, one citing health issues and religion while the other cited financial difficulty of not having health insurance. From the 19 patients who did take the flu shot this year, 4 patients cited barriers while trying to receive the flu shot. The low number of patients citing barriers is evidence that proves that the level of patient knowledge is high. In summary, the data suggest that patients largely perceive the flu vaccine as effective in preventing serious illness and that reported side effects are minimal. These findings support the importance of flu vaccinations in public health and align with the emphasis placed on them by organizations like the WHO and CDC to prevent the flu and reduce its impact. Conclusion/Action to take The Quality Assurance project at NYC HHC/Queens Hospital Center successfully surveyed 25 patients from July to August 2024 to gauge perspectives on flu vaccinations. The findings reveal a strong positive perception of the vaccine's effectiveness and minimal concern about side effects, with 76% of surveyed patients having received the vaccine. While little can be done for the 8% of patients who cannot get the flu vaccine due to medical or religious reasons, a targeted educational intervention for the 16% who decline for no specified reason could significantly increase vaccination rates. This approach would involve highlighting the risks of influenza and the vaccine's benefits through data-driven public advertisements, webinars, or community assemblies. This Q/A highlights the fact that the Diabetes’s center’s healthcare staff is doing an outstanding effort in educating the patients about the importance of the flu vaccine. These results can inform future public health initiatives, reinforcing the importance of continued efforts to promote flu vaccination and tailor patient education programs to further enhance vaccination rates. Declarations Statement on Participant Consent: All patients verbally consented to participate in the survey, and no personal participant identifiers were used in the data collection of this survey. References Centers for Disease Control and Prevention (2024), September 11 People at increased risk for flu complications. Retrieved from Centers for Disease Control and Prevention. (2024, September 17). How flu spreads. Retrieved from www.cdc.gov/flu/spread/index.html Centers for Disease Control and Prevention (2024), August 26 Seasonal flu. Retrieved from World Health Organization (2025), February 28 Influenza (Seasonal). Retrieved from ) Verket M, Jacobsen M, Schütt K, Marx N, Müller-Wieland D (2023) Influenza vaccination in patients affected by diabetes. Eur Heart J Supplements 25(SupplementA). https://doi.org/10.1093/eurheartjsupp/suac119 Name Date: MRN Confidential Patient Questionnaire Queens Hospital Center Diabetes Center of Excellence Please answer the following questions truthfully and to the best of your ability 1.Have you taken the flu vaccine this past year? Circle Yes No | If No, please explain If, Yes what was the experience like? 2.On a scale of 1–10(1 being least and 10 being most) how effective do you think the vaccine is against the flu? Please circle one number 1 2 3 4 5 6 7 8 9 10 3.Do you think there are any side effects for the flu vaccination? Circle Yes No | If Yes, please list below: 4.Did you experience any side effects from the flu vaccination? 5.Do you believe the flu is a serious disease? Circle Yes No | Please elaborate below: 6.Are you planning on taking the vaccine this year? Circle Yes No | If No please elaborate 7.Do you have any difficulty with transportation to a flu vaccination facility (ex: hospital, pharmacy, clinic)? Circle Yes No | If Yes please elaborate below 8.Do you have any difficulty with affording the flu vaccine? (ex: Insurance issues, etc… Circle: Yes No | If Yes please elaborate below 9.Do you have any disabilities that could possibly deter you from taking a flu vaccine? Circle Yes No | If Yes please elaborate below 10.Are there any health issues that are preventing you from taking the vaccine (ex: allergic to vaccine, conflict with current medications, underlying condition, etc… Circle Yes No | If Yes please elaborate below 11.Does your religious affiliation have an effect on your ability to take the flu vaccine? Circle Yes No | If Yes please elaborate 12.Any other comments/concerns regarding the flu vaccine and your ability to take it? Nombre Fecha MRN Cuestionario confidencial para pacientes Centro de Excelencia en Diabetes del Centro Hospitalario de Queens Por favor responda a las siguientes preguntas con sinceridad y lo mejor que pueda 1.¿Te has vacunado contra la gripe el año pasado? Círculo Sí No | Sí no, por favor explique En caso afirmativo ¿cómo fue la experiencia? 2.En una escala de 1–10 (1 siendo menos y 10 siendo más) ¿qué tan efectiva crees que es la vacuna contra la gripe? Por favor marque un círculo en un número: 1 2 3 4 5 6 7 8 9 10 3.¿Crees que hay algún efecto secundario de la vacuna contra la gripe? Círculo Sí No | En caso afirmativo, enumere a continuación: 4.¿Ha experimentado algún efecto secundario de la vacuna antigripal? 5.¿Crees que la gripe es una enfermedad grave? Círculo Sí No | Por favor, explique a continuación: 6.¿Estás planeando ponerte la vacuna este año? Círculo Sí No |Si no, por favor explique a continuación 7.¿Tiene alguna dificultad con el transporte a un centro de vacunación contra la gripe (por ejemplo, hospital, farmacia, clínica)? Círculo Sí No | En caso afirmativo, por favor, explique a continuación 8.¿Tienes alguna dificultad para pagar la vacuna contra la gripe? (Por ejemplo: ¿Problemas de seguro, etc… Círculo Sí No | En caso afirmativo, por favor, explique a continuación 9.¿Tienes alguna discapacidad que pueda disuadir de vacunarte contra la gripe Círculo: Sí No | En caso afirmativo, por favor, explique a continuación 10.¿Hay algún problema de salud que le impida tomar la vacuna (por ejemplo, alergia a la vacuna, conflicto con los medicamentos actuales, condición subyacente, etc.)? Círculo Sí No | En caso afirmativo, por favor, explique a continuación 11.¿Su afiliación religiosa tiene un efecto en su capacidad para vacunarse contra la gripe? Círculo Sí No | En caso afirmativo, por favor, elabore 12.¿Algún otro comentario/preocupación sobre la vacuna de la gripe y su capacidad para tomarla? Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8468430","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":566544576,"identity":"34f9fe37-128f-4deb-b1b9-f37864a7112a","order_by":0,"name":"Veda Sabarinath","email":"data:image/png;base64,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","orcid":"","institution":"","correspondingAuthor":true,"prefix":"","firstName":"Veda","middleName":"","lastName":"Sabarinath","suffix":""},{"id":566989096,"identity":"a541fe3b-22a4-48f8-b008-a03436d062fc","order_by":1,"name":"Isaac Sachmechi, MD, FACE, FACP","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA00lEQVRIiWNgGAWjYHACNhDBww8kmBkbSNEi2UCqFgaDA8RqkW8//OzRjQo7GePbPYafC3fYMfBLH7+AV4vBmTRz45wzyTxmd84YS888k8wg2ZdTgF8LQw6bdG7bAR6zGzlmzLxtB4CG8CTgd1j/G6CWfwd4jGcQq4XhBsiWhgM8BhJwLewH8DvsxjMz6ZxjyTwSN9KKpXnbknkke3jwWyLfn/xMOqfGzp5/RvLGz7xtdnL8POwP8OtBAA4DEAm0gseAWC1ww4m3ZRSMglEwCkYGAAAewT79wgN3tQAAAABJRU5ErkJggg==","orcid":"","institution":"Icahn School of Medicine at Mount Sinai, NYCHHC/Queens","correspondingAuthor":true,"prefix":"","firstName":"","middleName":"FACE MD Isaac","lastName":"Sachmechi","suffix":"MD"}],"badges":[],"createdAt":"2025-12-29 02:19:23","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-8468430/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8468430/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":100342237,"identity":"5608f2a9-69c0-45d3-80aa-1641ef2310a2","added_by":"auto","created_at":"2026-01-16 00:05:27","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":73540,"visible":true,"origin":"","legend":"","description":"","filename":"QueensHospitalQualityAnalysisProjectPaperFinal2.docx","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/f94ee0e2ef6621c45a6b697e.docx"},{"id":100342235,"identity":"79a05b7f-ce04-4cf6-ba6f-48fe657c1a88","added_by":"auto","created_at":"2026-01-16 00:05:27","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":342,"visible":true,"origin":"","legend":"","description":"","filename":"rs8468430.json","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/a480953bc79592d9113be7e6.json"},{"id":100373458,"identity":"109f5025-c5a8-408c-b6e7-2156b5cc08cb","added_by":"auto","created_at":"2026-01-16 08:14:33","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":34926,"visible":true,"origin":"","legend":"","description":"","filename":"rs84684300enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/0e82f22942def91c370c0db6.xml"},{"id":100342241,"identity":"b91c75c5-1fbd-49c5-8513-e7ce20137458","added_by":"auto","created_at":"2026-01-16 00:05:27","extension":"jpeg","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":70772,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/ade367d3ccce1008766bd2dd.jpeg"},{"id":100342239,"identity":"ac3ddba3-e8f5-46cc-8510-a73047bd137f","added_by":"auto","created_at":"2026-01-16 00:05:27","extension":"jpeg","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":78986,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/ca9fc13a5815f21aabe31379.jpeg"},{"id":100373165,"identity":"19a0fbe1-866d-4625-8224-ef5b6138393c","added_by":"auto","created_at":"2026-01-16 08:13:46","extension":"jpeg","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":113955,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage3.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/cf3900e72d6287f2d4783f03.jpeg"},{"id":100373140,"identity":"7db101ba-9fe4-4074-976d-38471e18b41a","added_by":"auto","created_at":"2026-01-16 08:13:43","extension":"png","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":30405,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/472d0d04b9cbf62ff7ce4161.png"},{"id":100373218,"identity":"f28dfa09-92e4-4677-afdb-5f4c1613b63d","added_by":"auto","created_at":"2026-01-16 08:13:51","extension":"jpeg","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":103065,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage5.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/b23a47f82f099770e18fba36.jpeg"},{"id":100342250,"identity":"5c1c50b1-e0c0-4ef5-b2c6-56c4f7449569","added_by":"auto","created_at":"2026-01-16 00:05:27","extension":"png","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":14681,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/e9a1e43520b8eb54f1a35fb0.png"},{"id":100342252,"identity":"5fcbadfc-f806-4180-9da9-e31f9e347779","added_by":"auto","created_at":"2026-01-16 00:05:27","extension":"png","order_by":9,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":21739,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/fdecb22816f3161ab95c858d.png"},{"id":100342249,"identity":"630bdd22-7151-4ebe-a3a4-fece8cb01ebd","added_by":"auto","created_at":"2026-01-16 00:05:27","extension":"png","order_by":10,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":29096,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/deec939d34653077e02f72c1.png"},{"id":100342248,"identity":"4912ed20-6155-4236-bb0f-f7b3fc390b93","added_by":"auto","created_at":"2026-01-16 00:05:27","extension":"png","order_by":11,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11010,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/7b7bdcf73ac05ac390d71806.png"},{"id":100342246,"identity":"23d7fcf7-a252-486a-b08f-5c1475f8c191","added_by":"auto","created_at":"2026-01-16 00:05:27","extension":"png","order_by":12,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":27201,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage5.png","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/43a2eeb360be6408a00adfb2.png"},{"id":100342253,"identity":"95923b38-4886-4ecf-a003-098f40a8d71c","added_by":"auto","created_at":"2026-01-16 00:05:27","extension":"xml","order_by":13,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":31413,"visible":true,"origin":"","legend":"","description":"","filename":"rs84684300structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/8982d6edb5902293d8da37e2.xml"},{"id":100342251,"identity":"8ad94810-0232-4267-84b9-60ff247f5977","added_by":"auto","created_at":"2026-01-16 00:05:27","extension":"html","order_by":14,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":39914,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/ef105c822d4acef66d277e07.html"},{"id":100342234,"identity":"14287d9f-cce0-4e24-88f7-384234271b03","added_by":"auto","created_at":"2026-01-16 00:05:27","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":21273,"visible":true,"origin":"","legend":"\u003cp\u003eThis pie chart presents the percentage of surveyed patients who reported taking the flu vaccine compared to those who did not.\u003c/p\u003e","description":"","filename":"Figure1QAProjectQueens.png","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/814ff06f750359cfa3913995.png"},{"id":100342236,"identity":"3d2a4951-6f0a-408c-b0bf-66941fc3a6bf","added_by":"auto","created_at":"2026-01-16 00:05:27","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":12515,"visible":true,"origin":"","legend":"\u003cp\u003eThis figure illustrates the patients’ knowledge about the flu as a serious disease.\u003c/p\u003e","description":"","filename":"Figure2QAProjectQueens.png","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/a511ef7f2be1f58ff332add5.png"},{"id":100373201,"identity":"0056c5fd-9a33-4ada-b9bc-a291eab20a5b","added_by":"auto","created_at":"2026-01-16 08:13:50","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":14966,"visible":true,"origin":"","legend":"\u003cp\u003eThis figure displays the reported incidence of side effects among surveyed patients who took the flu vaccine.\u003c/p\u003e","description":"","filename":"Figure3QAProjectQueens.png","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/886f9f1fb59e84043a429226.png"},{"id":100373202,"identity":"ed0fe6fc-cc15-46a1-9c7e-fbbbe2ac1dab","added_by":"auto","created_at":"2026-01-16 08:13:50","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":15090,"visible":true,"origin":"","legend":"\u003cp\u003eThis pie chart shows the distribution of patient perceptions regarding the effectiveness of the flu vaccination.\u003c/p\u003e","description":"","filename":"Figure42QAProjectQueens.png","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/b4460d32d97b8c339575adb2.png"},{"id":100342243,"identity":"f5d0e4f2-c289-4a74-902d-2a6488708453","added_by":"auto","created_at":"2026-01-16 00:05:27","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":37566,"visible":true,"origin":"","legend":"\u003cp\u003eThis bar graph illustrates the number of surveyed patients who cited barriers that prevented them from receiving the flu vaccination.\u003c/p\u003e","description":"","filename":"Figure5QAProjectQueens.png","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/94b9fd17cc9f955beb147885.png"},{"id":100383959,"identity":"d4c3eba3-e14a-485e-abfe-93c3a0c42762","added_by":"auto","created_at":"2026-01-16 10:48:57","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":341564,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8468430/v1/8d6a2c0d-f5c0-4169-97df-238f1bb9c518.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eA Quality Assurance (QA) Project on Flu Vaccinations in Queens Hospital Diabetes Clinic\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe common flu, also known as Influenza, is a highly contagious respiratory illness caused by influenza viruses. It can lead to mild to severe illness and, in extreme cases, hospitalization or even death, although this is mostly seen in high-risk populations such as the elderly, young children, pregnant women, and those with chronic illnesses (Centers for Disease Control and Prevention, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). The flu is most commonly spread through droplets when an infected person coughs, sneezes, or talks, and it can cause symptoms such as fever, cough, sore throat, body aches, fatigue, and in severe cases, pneumonia or organ failure (Centers for Disease Control and Prevention, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Every year, seasonal flu outbreaks affect millions of people worldwide, placing a significant strain on healthcare systems, especially during peak flu season. The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC)\u003c/p\u003e \u003cp\u003eemphasize the importance of influenza vaccination as the most effective way to prevent the flu and reduce its impact on public health (World Health Organization \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Vaccines are specifically designed to protect individuals from the flu strains predicted to be most prevalent this year (World Health Organization, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Taking the flu vaccination has its implications for diabetic patients, especially. Patients with Type 2 Diabetes have an increased risk for a more\u003c/p\u003e \u003cp\u003esevere course of influenza virus infection. There is increasing evidence that influenza vaccination in patients with diabetes can safely reduce all-cause mortality and cardiovascular death. From our point of view, it should be an integral part of treatment strategies in patients with diabetes (Verket et. al, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis survey was conducted using a questionnaire form, which was distributed to patients who came into the Diabetes Clinic for their appointments. The questionnaire had 12 questions and was administered in both English and Spanish. 25 patients were interviewed. Data was analyzed using Google Sheets, and graphs were generated using Quadratic.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eData was collected from the patients using the responses from the questionnaire. Looking at patterns, trends, and correlations between categories, responses culminate in the following (See Figs.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThis pie chart presents the percentage of surveyed patients who reported taking the flu vaccine compared to those who did not.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThis figure illustrates the patients\u0026rsquo; knowledge about the flu as a serious disease.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThis figure displays the reported incidence of side effects among surveyed patients who took the flu vaccine.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThis pie chart shows the distribution of patient perceptions regarding the effectiveness of the flu vaccination.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThis bar graph illustrates the number of surveyed patients who cited barriers that prevented them from receiving the flu vaccination.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe data collected provides insights into patient experiences. Of the 25 patients surveyed, 76% (19 patients) reported taking the flu vaccine, while 24% (6 patients) did not (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). When assessing the surveyed patients\u0026rsquo; knowledge regarding the flu, 14 of the 25 respondents believed the flu is considered a serious disease. At the same time, 9 out of 25 reported that they did not think it was a serious disease, and 2 patients had no response (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). This data shows that most patients are aware of the seriousness of the flu and are well educated on this matter.\u003c/p\u003e \u003cp\u003eRegarding side effects of the flu vaccination, 18 of the 25 respondents answered \u0026ldquo;No\u0026rdquo; to side effects, while 6 patients responded \u0026ldquo;Yes\u0026rdquo;(Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Figure\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e illustrates patient perceptions of the vaccine's effectiveness. A substantial 72% of respondents said yes to the flu vaccine being effective, indicating a very high perceived effectiveness. On the other hand, only 28% of the sample population said no to the flu vaccine being effective. This overwhelmingly positive perception of effectiveness aligns with the hospital\u0026rsquo;s Diabetes clinic\u0026rsquo;s goal of 100% patient\u003c/p\u003e \u003cp\u003ecompliance for the flu vaccine and suggests that patients generally consider the flu vaccine to be highly effective. Lastly, several barriers to receiving the vaccine were surveyed, including transportation, health, religious, and financial difficulties. From these categories, 2 patients reported transportation, 3 reported health issues, and 1 patient for religious and financial difficulties (Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). Out of the 6 patients who didn\u0026rsquo;t take the flu shot this year(24% of total sample size), only 2 cited barriers as to why they couldn\u0026rsquo;t take the flu shot, one citing health issues and religion while the other cited financial difficulty of not having health insurance. From the 19 patients who did take the flu shot this year, 4 patients cited barriers while trying to receive the flu shot. The low number of patients citing barriers is evidence that proves that the level of patient knowledge is high. In summary, the data suggest that patients largely perceive the flu vaccine as effective in preventing serious illness and that reported side effects are minimal.\u003c/p\u003e \u003cp\u003eThese findings support the importance of flu vaccinations in public health and align with the emphasis placed on them by organizations like the WHO and CDC to prevent the flu and reduce its impact.\u003c/p\u003e"},{"header":"Conclusion/Action to take","content":"\u003cp\u003eThe Quality Assurance project at NYC HHC/Queens Hospital Center successfully surveyed 25 patients from July to August 2024 to gauge perspectives on flu vaccinations. The findings reveal a strong positive perception of the vaccine's effectiveness and minimal concern about side effects, with 76% of surveyed patients having received the vaccine. While little can be done for the 8% of patients who cannot get the flu vaccine due to medical or religious reasons, a targeted educational intervention for the 16% who decline for no specified reason could significantly increase vaccination rates. This approach would involve highlighting the risks of influenza and the vaccine's benefits through data-driven public advertisements, webinars, or community assemblies. This Q/A highlights the fact that the Diabetes\u0026rsquo;s center\u0026rsquo;s healthcare staff is doing an outstanding effort in educating the patients about the importance of the flu vaccine. These\u003c/p\u003e \u003cp\u003eresults can inform future public health initiatives, reinforcing the importance of continued efforts to promote flu vaccination and tailor patient education programs to further enhance vaccination rates.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eStatement on Participant Consent: All patients verbally consented to participate in the survey, and no personal participant identifiers were used in the data collection of this survey.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eCenters for Disease Control and Prevention (2024), September 11 People at increased risk for flu complications. Retrieved from \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e\u003c/span\u003e\u003cspan address=\"http://www.cdc.gov/flu/highrisk/index.htm\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e Centers for Disease Control and Prevention. (2024, September 17). How flu spreads. Retrieved from www.cdc.gov/flu/spread/index.html\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCenters for Disease Control and Prevention (2024), August 26 Seasonal flu. Retrieved from \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e\u003c/span\u003e\u003cspan address=\"http://www.cdc.gov/flu/signs-symptoms/index.html\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization (2025), February 28 Influenza (Seasonal). Retrieved from \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e\u003c/span\u003e\u003cspan address=\"http://www.who.int/news-room/fact-sheets/detail/influenza-(seasonal\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e)\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVerket M, Jacobsen M, Sch\u0026uuml;tt K, Marx N, M\u0026uuml;ller-Wieland D (2023) Influenza vaccination in patients affected by diabetes. Eur Heart J Supplements 25(SupplementA). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1093/eurheartjsupp/suac119\u003c/span\u003e\u003cspan address=\"10.1093/eurheartjsupp/suac119\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eName Date: MRN\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eConfidential Patient Questionnaire\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eQueens Hospital Center Diabetes Center of Excellence\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePlease answer the following questions truthfully and to the best of your ability 1.Have you taken the flu vaccine this past year?\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCircle Yes No | If No, please explain\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIf, Yes what was the experience like? 2.On a scale of 1\u0026ndash;10(1 being least and 10 being most) how effective do you think the vaccine is against the flu?\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePlease circle one number 1 2 3 4 5 6 7 8 9 10 3.Do you think there are any side effects for the flu vaccination?\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCircle Yes No | If Yes, please list below: 4.Did you experience any side effects from the flu vaccination? 5.Do you believe the flu is a serious disease?\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCircle Yes No | Please elaborate below: 6.Are you planning on taking the vaccine this year?\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCircle Yes No | If No please elaborate 7.Do you have any difficulty with transportation to a flu vaccination facility (ex: hospital, pharmacy, clinic)?\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCircle Yes No | If Yes please elaborate below 8.Do you have any difficulty with affording the flu vaccine? (ex: Insurance issues, etc\u0026hellip; Circle: Yes No | If Yes please elaborate below 9.Do you have any disabilities that could possibly deter you from taking a flu vaccine?\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCircle Yes No | If Yes please elaborate below 10.Are there any health issues that are preventing you from taking the vaccine (ex: allergic to vaccine, conflict with current medications, underlying condition, etc\u0026amp;#8230\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCircle Yes No | If Yes please elaborate below 11.Does your religious affiliation have an effect on your ability to take the flu vaccine?\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCircle Yes No | If Yes please elaborate 12.Any other comments/concerns regarding the flu vaccine and your ability to take it?\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNombre Fecha\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMRN\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCuestionario confidencial para pacientes\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCentro de Excelencia en Diabetes del Centro Hospitalario de Queens\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePor favor responda a las siguientes preguntas con sinceridad y lo mejor que pueda 1.\u0026iquest;Te has vacunado contra la gripe el a\u0026ntilde;o pasado?\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eC\u0026iacute;rculo S\u0026iacute; No | S\u0026iacute; no, por favor explique\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEn caso afirmativo \u0026iquest;c\u0026oacute;mo fue la experiencia? 2.En una escala de 1\u0026ndash;10 (1 siendo menos y 10 siendo m\u0026aacute;s) \u0026iquest;qu\u0026eacute; tan efectiva crees que es la vacuna contra la gripe?\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePor favor marque un c\u0026iacute;rculo en un n\u0026uacute;mero: 1 2 3 4 5 6 7 8 9 10 3.\u0026iquest;Crees que hay alg\u0026uacute;n efecto secundario de la vacuna contra la gripe?\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eC\u0026iacute;rculo S\u0026iacute; No | En caso afirmativo, enumere a continuaci\u0026oacute;n: 4.\u0026iquest;Ha experimentado alg\u0026uacute;n efecto secundario de la vacuna antigripal? 5.\u0026iquest;Crees que la gripe es una enfermedad grave?\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eC\u0026iacute;rculo S\u0026iacute; No | Por favor, explique a continuaci\u0026oacute;n: 6.\u0026iquest;Est\u0026aacute;s planeando ponerte la vacuna este a\u0026ntilde;o?\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eC\u0026iacute;rculo S\u0026iacute; No |Si no, por favor explique a continuaci\u0026oacute;n 7.\u0026iquest;Tiene alguna dificultad con el transporte a un centro de vacunaci\u0026oacute;n contra la gripe (por ejemplo, hospital, farmacia, cl\u0026iacute;nica)?\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eC\u0026iacute;rculo S\u0026iacute; No | En caso afirmativo, por favor, explique a continuaci\u0026oacute;n 8.\u0026iquest;Tienes alguna dificultad para pagar la vacuna contra la gripe? (Por ejemplo: \u0026iquest;Problemas de seguro, etc\u0026amp;#8230\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eC\u0026iacute;rculo S\u0026iacute; No | En caso afirmativo, por favor, explique a continuaci\u0026oacute;n 9.\u0026iquest;Tienes alguna discapacidad que pueda disuadir de vacunarte contra la gripe C\u0026iacute;rculo: S\u0026iacute; No | En caso afirmativo, por favor, explique a continuaci\u0026oacute;n 10.\u0026iquest;Hay alg\u0026uacute;n problema de salud que le impida tomar la vacuna (por ejemplo, alergia a la vacuna, conflicto con los medicamentos actuales, condici\u0026oacute;n subyacente, etc.)?\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eC\u0026iacute;rculo S\u0026iacute; No | En caso afirmativo, por favor, explique a continuaci\u0026oacute;n 11.\u0026iquest;Su afiliaci\u0026oacute;n religiosa tiene un efecto en su capacidad para vacunarse contra la gripe?\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eC\u0026iacute;rculo S\u0026iacute; No | En caso afirmativo, por favor, elabore 12.\u0026iquest;Alg\u0026uacute;n otro comentario/preocupaci\u0026oacute;n sobre la vacuna de la gripe y su capacidad para tomarla?\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"NYCHHC","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Quality Assurance Project, Flu Vaccine, Diabetes, NYC HHC Queens","lastPublishedDoi":"10.21203/rs.3.rs-8468430/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8468430/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe Diabetes Clinic at NYC HHC/Queens Hospital Center decided to conduct a Quality Assurance project aiming to gauge the patients’ perspective on the effectiveness, accessibility, and adverse effects of the flu vaccine. This survey was conducted from July to August 2024. The survey was administered via a confidential questionnaire in which patients were asked to fill out a series of questions assessing their knowledge, experience, side effects, accessibility, and willingness to take it in the future. The questionnaire was administered in both English and Spanish.\u003c/p\u003e","manuscriptTitle":"A Quality Assurance (QA) Project on Flu Vaccinations in Queens Hospital Diabetes Clinic","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-16 00:05:16","doi":"10.21203/rs.3.rs-8468430/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d849a871-6464-416c-a244-5bbd94b8c1e2","owner":[],"postedDate":"January 16th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":60499617,"name":"Preventive Medicine"},{"id":60499618,"name":"Epidemiology"},{"id":60499619,"name":"Statistical Epidemiology"}],"tags":[],"updatedAt":"2026-01-16T00:05:16+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-16 00:05:16","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8468430","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8468430","identity":"rs-8468430","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}