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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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