IMMUNIZATION AGAINST INFLUENZA AMONG PEOPLE AGED OVER 65 LIVING AT HOME IN LEICESTERSHIRE DURING WINTER 1991-2

Objectives-To assess the size of the elderly population for whom influenza vaccine is indicated and how many are vaccinated. Design-Cohort questionnaire study. Setting-Leicestershire general practices. Subjects-800 elderly subjects selected at random from the Leicestershire family health services authority list who were not living in residential care, 565 of whom returned a questionnaire. Main outcome measures-Patient profile, vaccine offers, vaccination status, and reasons for not accepting vaccine. Results-170 of 334 (51%) people aged 65-74 years and 106 of 205 (52%) aged greater-than-or-equal-to 75 years had one or more medical indications for influenza vaccine. 195 people were offered vaccine, 49 of whom had no risk factor. 152 offers were made opportunistically during visits to the practice and only six were made in writing or by telephone. Overall 113 of 266 patients with known medical indications were immunised. Vaccine was accepted by 148 of 189 (78%) offered it, and, as judged by acceptance in sequential years, influenza vaccine was well tolerated. The main reasons for not being vaccinated were misconception about risk status and inadequate advice from doctors. Conclusions-The prevalence of medical indications for vaccine is not large enough to justify a policy of universal immunisation. Most patients offered vaccine accept it and tolerate it well. Improved targeting and education is needed to increase immunisation of people at risk.