"McFlu" - The Monroe County, New York, Medicare vaccine demonstration

Background: Monroe County (MC) NY was one of 9 original sites for the 1988- 1992 Medicare Influenza Vaccine Demonstration, which led to Medicare covera ge of annual influenza vaccination. The "McFlu" project involved collaborat ion among university, health department, and practice community. Methods: Community-wide systems for promoting and/or documenting influenza vaccine delivery and for conducting laboratory-based influenza surveillance were established in MC and in neighboring Onondaga County (OC), which serv ed as a comparison site without Medicare coverage of vaccination. Vaccinati on utilization and virologic surveillance data collected from physician pra ctices, hospitals, and nursing homes were furnished to national demonstrati on evaluators. Results: Influenza vaccination rates among persons greater than or equal to 65 years of age increased from 41% to 74% in MC compared to an increase fr om 46% to 57% in OC. The greatest increase occurred in physician offices ut ilizing an innovative vaccination promotion and tracking strategy. Communit y-wide influenza A/H3N2 and B outbreaks were documented in three successive demonstration years, affording investigators the opportunity to better def ine influenza impact and vaccine effectiveness among the Medicare populatio n. Conclusions: The McFlu project exemplifies the potential for linking the ac ademic and public health sectors to complement each others' strengths in pl anning, implementing and documenting a targeted program for improving commu nity health. This model of medicine and public health collaboration should be applicable to attaining other well articulated goals for the health of t he public.