McFlu - The Monroe County, New York, Medicare vaccine demonstration

Background: Monroe County (MC) NY was one of 9 original sites for the 1988-1992 Medicare Influenza Vaccine Demonstration, which led to Medicare coverage of annual influenza vaccination. The "McFlu" project involved collaboration among university, health department, and practice community. Methods: Community-wide systems for promoting and/or documenting influenza vaccine delivery and for conducting laboratory-based influenza surveillance were established in MC and in neighboring Onondaga County (OC), which served as a comparison site without Medicare coverage of vaccination. Vaccination utilization and virologic surveillance data collected from physician practices, hospitals, and nursing homes were furnished to national demonstration evaluators. Results: Influenza vaccination rates among persons greater than or equal to 65 years of age increased from 41% to 74% in MC compared to an increase from 46% to 57% in OC. The greatest increase occurred in physician offices utilizing an innovative vaccination promotion and tracking strategy. Community-wide influenza A/H3N2 and B outbreaks were documented in three successive demonstration years, affording investigators the opportunity to better define influenza impact and vaccine effectiveness among the Medicare population. Conclusions: The McFlu project exemplifies the potential for linking the academic and public health sectors to complement each others' strengths in planning, implementing and documenting a targeted program for improving community health. This model of medicine and public health collaboration should be applicable to attaining other well articulated goals for the health of the public.