Perspectives in Disease Prevention and Health Promotion
State and Local Influenza Immunization Program Activities
Influenza prevention and control efforts in the United States have
relied on cooperation between federal, state, and local public
health
agencies and private sector providers. Since the 1979-80 influenza
season, public sector resources for influenza control have been
provided primarily by state and local health agencies.
Between the 1985-86 and 1986-87 influenza seasons, the number of
state
and local projects offering influenza vaccine increased markedly.
During the 1985-86 influenza season, 20 of 63 federal immunization
grant-supported localities reported purchasing approximately
1,710,024
doses of influenza vaccine for use in public clinics. During the
1986-87 influenza season, 36 localities reported purchasing
2,179,485
doses of influenza vaccine. Compared with the previous year, the
activities in 1986-87 represented increases of 80% in project
participation and 27% in the number of doses purchased.
Programs in Allegheny County, Pennsylvania, and in California and
Vermont illustrate state and local efforts to improve influenza
vaccine
coverage.
Allegheny County, Pennsylvania. During the 1986-87 influenza
season,
the Allegheny County Health Department conducted expanded outreach
clinics to immunize high-risk persons against influenza. Of the
10,200
persons residing in nursing home facilities, 8529 (84%) received
vaccine provided by the health department. Previous immunization
coverage levels in Allegheny County nursing homes ranged from a low
of
36% in the 1979-80 influenza season to a high of 71% during the
1985-86
season. An additional 43,926 doses were administered in health
department clinics, hospital outpatient departments, community
clinics,
and senior citizen facilities. An estimated 21% of the 210,000
persons
greater than or equal to65 years of age who were not in
long-term-care
facilities received publicly purchased vaccine. Allegheny County
coordinated the development of a coalition involving the American
Lung
Association (ALA) of Western Pennsylvania and other health-care
organizations that conducted surveys to measure the impact of and
coverage levels for their programs. A telephone survey conducted by
the
ALA at the conclusion of the 1986-87 influenza season showed
overall
influenza vaccination rates of 32% in noninstitutionalized persons
aged
greater than or equal to65 years in the general population. The ALA
publicized the recommendations and distributed educational material
to
high-risk groups (1).
California. The State of California, through the California
Department
of Health Services (CDHS), distributed over 481,000 doses of
influenza
vaccine, of which over 350,000 doses were administered to
approximately
12% of California residents greater than or equal to65 years of
age.
This program, in operation since 1974, is funded entirely through
state
general revenue funds. The CDHS distributes vaccine to 59 county
and
municipal health departments. Fees up to $2.00 may be charged by
local
units to defray administrative costs. Vaccine is offered at clinics
to
all persons greater than or equal to55 years of age and to persons
of
any age with certain chronic illnesses. Staff for outreach clinics
and
nursing home programs is provided jointly by California chapters of
the
American Red Cross and state and local health departments.
Vermont. The Vermont Department of Health receives a yearly grant
from
Blue Cross/Blue Shield of Vermont to support the purchase of
influenza
vaccine for an immunization program for persons greater than or
equal
to60 years of age and persons of all ages with high-risk
conditions.
Vaccine is distributed to home health agencies and visiting nurse
associations that provide staffing and clinic coordination. Area
Offices on Aging provide additional coordination and publicity
through
a newsletter distributed to senior citizens of Vermont. During the
1987-88 influenza season, approximately 11,000 persons received
influenza vaccine through this program.
Reported by: Allegheny County Health Dept, Pittsburgh; R David, MD,
Acting State Epidemiologist, Pennsylvania Dept of Health. DO Lyman,
MD,
State Epidemiologist, California Dept of Health Svcs. RL Vogt, MD,
State Epidemiologist, Vermont Dept of Health. Div of Immunization,
Center for Prevention Svcs, CDC.
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