Influenza vaccine use among an elderly population in a community intervention.

A community intervention program was carried out to promote influenza immunization among an elderly population, as part of a demonstration established to estimate the value of including influenza immunization as a Medicare-covered benefit. Potential recipients were informed of reasons for receiving vaccine and its availability at no cost, and physicians and others administering it were provided with educational materials and cost reimbursement. Data collected for annual evaluations of influenza vaccine effectiveness were used to evaluate the impact of the community intervention program on influenza immunization status and to determine the effects of age, gender, chronic health conditions, and smoking status on the likelihood of immunization. Results indicated that the intervention program had a statistically significant impact on increasing the likelihood of immunization among the elderly population living in the targeted area. The existence of certain chronic health conditions also predicted immunization, while the effect of current smoking on immunization was strongly negative. During the three years of vaccine promotion, use in those 65 years and older who resided in the intervention area increased from approximately 40% in 1989-1990 to over 56% in 1991-1992. With various incentives, including cost reimbursement through Medicare, influenza immunization can be markedly increased among elderly beneficiaries.