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The Influenza Vaccination Demonstration Project: An Expanded Policy Goal

Published online by Cambridge University Press:  21 June 2016

David S. Fedson*
Affiliation:
Division of General Medicine, Department of Medicine, University of Virginia Health Sciences Center, Charlottesville, Virginia
*
Box 494, University of Virginia Health Sciences Center, Charlottesville, VA 22908

Abstract

In 1980, the Public Health Service established an objective of immunizing 60% of high-risk persons with influenza vaccine annually by the year 1990. As no more than 32% of high-risk persons currently receive influenza vaccine each year, the Health Care Financing Administration (HCFA) has undertaken an influenza vaccination demonstration project for Medicare enrollees. Federally purchased vaccine is being distributed to physicians, health departments, hospitals, nursing homes and health maintenance organizations (HMOs). If the project is cost-effective, Congress has authorized HCFA reimbursement for influenza vaccination. Changing reimbursement policy alone, however, is unlikely to substantially improve influenza vaccine delivery; HCFA reimbursement for pneumococcal immunization since 1981 has not increased the use of pneumococcal vaccine. In contrast, federal purchase and distribution of vaccines to state and local health departments has helped maintain the remarkable success of childhood immunization programs. In addition, in Canada, provincial health departments purchase more than 80% of all influenza vaccine distributed, and from 1980 through 1988, per capita vaccine distribution increased 140%. These experiences suggest the need for an expanded policy goal for the influenza vaccination demonstration project that includes federal purchase and distribution of influenza vaccine. This approach, together with a change in reimbursement policy, offers greater promise for achieving our nation's objective for influenza vaccination.

Type
Special Commentary
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1990

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References

1.Lui, KJ, Kendal, AP. Impact of influenza epidemics on mortality in the United States from October 1972 to May 1985. Am J Public Health. 1981;77:712716.Google Scholar
2.Perrotta, DM, Decker, M, Glezen, WP. Acute respiratory disease hospitalizations as a measure of impact of epidemic influenza. Am J Epidemiol. 1985;122:468476.Google Scholar
3.Barker, WH. Excess pneumonia and influenza associated hospitalization during influenza epidemics in the United States, 1970-78. Am J Public Health. 1986;76:761765.Google Scholar
4.Riddiough, MA, Sisk, JE, Bell, JC. Influenza vaccination: cost effectiveness and public policy. JAMA. 1983;249:31893195.Google Scholar
5.Public Health Service. Promoting Health/Preventing Disease: Objectives for the Nation. Washington, DC: United States Department of Health and Human Services, Public Health Service; 1980:2124.Google Scholar
6.Centers for Disease Control. State and local influenza immunization program activities. MMWR. 1988;37:705707.Google Scholar
7.Centers for Disease Control. Influenza vaccination levels in selected states-behavioral risk factor surveillance system, 1987. MMWR. 1989;38:124,129133.Google Scholar
8.Centers for Disease Control. Progress toward achieving the national 1990 objectives for immunization. MMWR. 1989;38:613617.Google Scholar
9.Fedson, DS. Influenza and pneumococcal immunization strategies for physicians. Chest. 1987;91:436443.Google Scholar
10.Meitl, JF. Influenza immunization for Medicare eligibles: a demonstration, for cost-effectiveness. In: 22nd Immunization Conference Proceedings. Atlanta, Ga: United States Department of Health and Human Services, Public Health Service; 1988:117118.Google Scholar
11.Centers for Disease Control. Pneumococcal polysaccharide vaccine. MMWR, 1989;38:64-68,7376.Google Scholar
12.McPhee, SJ, Schroeder, SA. Promoting preventive care: changing reimbursement is not enough. Am J Public Health. 1987;77:780781.Google Scholar
13.Hinman, AR. Public health considerations. In: Plotkin, SA, Mortimer, EA Jr., eds. Vaccines. Philadelphia, Pa: WB Saunders Company; 1988:587611.Google Scholar
14.Fedson, DS. Influenza prevention and control: past practices and future prospects. Am J Med. 1987;82(6A):4247.Google Scholar