EVALUATION OF GROUP-HEALTH-COOPERATIVE-OF-PUGET-SOUNDS SENIOR INFLUENZA IMMUNIZATION PROGRAM

The goal of this study was to identify areas in which an influenza imm unization campaign for seniors, sponsored by a health maintenance orga nization (HMO), could be improved. This study was conducted at Group H ealth Cooperative of Puget Sound (GHC), serving approximately 470,000 enrollees in Washington State. A survey was administered to two groups of seniors drawn at random-those who received influenza vaccine and t hose who did not, during the fall and winter of 1991. Immunization rat es were almost 75 percent for ''well'' seniors and 85 percent for ''ch ronically ill'' seniors. Bivariant analysis showed that two activities of the influenza campaign were associated with vaccine compliance: a provider-generated recruitment letter and exposure to an immunization article in the enrollee newsletter. Using a broader framework for pred icting vaccine compliance, logistic regression showed that vaccine com pliance was associated positively with previous immunizations and beli ef that ''my doctor wants me to get a shot, '' and negatively with fea r of adverse reaction and belief that the vaccine is ineffective. Ther e were few suggestions for improving the immunization program, among b oth vaccinated and unvaccinated enrollees. Approximately two-thirds of unvaccinated enrollees said there was nothing GHC could do to convinc e them to be vaccinated. These findings suggest high vaccine complianc e and satisfaction with an HMO-sponsored influenza campaign. Strategie s and potential to further increase vaccination rates are discussed.