Many strategies have been applied to increase seasonal influenza vaccination; however, gaps in coverage remain. We synthesized the evidence on effectiveness of implementation strategies to increase seasonal influenza vaccination among U.S. adults. Studies performed from February 2010-August 2023 in the United States, focused on seasonal influenza vaccination, and measuring uptake and coverage were included. Guidance from Cochrane was followed. Interventions were mapped to Expert Recommendations for Implementing Change strategies. A total of 1,585 non-duplicate records were identified, full-text screening was performed for 353 records, and 51 studies met inclusion criteria. Among these studies, implementation strategies included those that engaged consumers, trained and educated stakeholders, and supported providers. Considerable heterogeneity was found in the study setting, populations, design, and methods. Substantial study variation limits the ability to conclude which strategies are most effective at increasing influenza vaccination uptake and coverage in U.S. adults.

The rate of emergency department visits with a primary diagnosis of a substance use disorder among adults increased from 74.4 per 10,000 population during 2018–2019 to 103.8 during 2020–2021. Between these two periods, this rate increased 42% among patients aged 18–34 years (from 86.1 to 122.5) and 38% among patients aged ≥35 years (from 69.5 to 96.1). During both 2018–2019 and 2020–2021, adults aged 18–34 years were more likely to visit an emergency department for substance abuse, use, or dependence than were those aged ≥35 years.