“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 coverage of annual influenza vaccination. The “McFlu” project involved collaboration 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 served as a comparison site without Medicare coverage of vaccination. Vaccination utilization and virologic surveillance data collected from physician practices, hospitals, and nursing homes were furnished to national demonstration evaluators. Results: Influenza vaccination rates among persons ≥65 years of age increased from 41% to 74% in MC compared to an increase from 46% to 57% in OC. The greatest increase occurred in physician offices utilizing an innovative vaccination promotion and tracking strategy. Community-wide influenza A/H3N2 and B outbreaks were documented in three successive demonstration years, affording investigators the opportunity to better define influenza impact and vaccine effectiveness among the Medicare population. Conclusion: The McFlu project exemplifies the potential for linking the academic and public health sectors to complement each others’ strengths in planning, implementing and documenting a targeted program for improving community health. This model of medicine and public health collaboration should be applicable to attaining other well articulated goals for the health of the public.