OBJECTIVE: To determine if mailed reminders would increase area-wide influe
nza immunization for persons aged 65 and older. DESIGN: A randomized, contr
olled trial.
SETTING: Ten counties in Indiana.
PARTICIPANTS: Using a Medicare database, 10,000 subjects were selected rand
omly from 10 counties in Indiana and randomized for the study. Using pre-es
tablished criteria, 4503 persons in the control group and 4508 in the inter
vention group were eligible for study.
INTERVENTION: Intervention subjects received mailed reminders during the im
munization season of 1995.
MEASUREMENTS: Data from mailed surveys, Medicare claims, and phone calls we
re used to determine immunization rates.
RESULTS: Of those surveyed who received immunization, only 63.4% filed a Me
dicare claim. Immunization rates were high in both groups but higher in the
intervention group, 69.0% versus 64.2%. Age, presence of lung disease, ass
ignment to the intervention group, presence of heart disease, and an age-se
x interaction term were significantly and independently related to immuniza
tion.
CONCLUSIONS: The Healthy People Year 2000 goal (60% immunization for person
s 65 and older) was exceeded in this population. Medicare claims data do no
t reflect immunization rates accurately. Mailed reminders, an inexpensive i
ntervention, increased immunization rates area-wide and have potential for
cost savings.