Flu & Pneumonia

Once assessment and planning have been completed, including analysis of the collected data, the next step is implementing the strategies and interventions that will comprise the workplace health program. The intervention descriptions on this page include the public health evidence-base for each intervention, details on designing interventions for adult immunization, and links to examples and resources.

Before implementing any interventions, the evaluation plan should also be developed. Potential baseline, process, health outcomes, and organizational change measures for these programs are listed under evaluation of adult immunization programs.

Vaccine-preventable diseases are infectious diseases that can be prevented by immunization (vaccination). Traditionally, vaccines have been associated with protecting young children, but far too many adults become ill, are disabled, and die each year from diseases that could easily have been prevented by vaccines. Vaccines not only prevent disease in the people who receive them but often create “herd immunity,” meaning that even unvaccinated individuals are at lower risk of disease if most of their community is immunized. Everyone from young adults to older adults can benefit from immunizations.

Among vaccine-preventable diseases in adults, influenza has the greatest impact in the U.S. population.

  • An average of 36,000 deaths and over 200,000 hospitalizations associated with influenza occur each year in the United States1-2
  • The combination of influenza and pneumonia was the eighth leading cause of death among all persons in the United States in 2005, accounting for 63,000 deaths3
  • The overall national economic burden of influenza-attributable illness for adults, age 18 years and above is $83.3 billion. Direct medical costs for influenza in adults totaled $8.7 billion including $4.5 billion for adult hospitalizations resulting from influenza-attributable illness4
  • Influenza is also responsible for substantial indirect costs ($6.2 billion annually), mainly from lost productivity. Each year, among adults age 18 to 64 years, 17 million workdays are lost to influenza-related illness5

In Rankings of Preventative Services for the U.S. Population, the Partnership for Prevention provides an approach to ranking preventive services according to their clinically preventable burden (CPB) and cost effectiveness (CE). CPB is the disease, injury and premature death that would be prevented if the service were delivered to all people in the target population. With this approach, influenza vaccination for adults age 50 years and above received a ranking of 8 on a scale of 1-10, with 10 being the highest ranking.

The National Advisory Committee on Immunization Practices (ACIP) consists of a 15 member expert panel convened by the U.S. Department of Health and Human Services (DHHS) to provide advice and guidance to DHHS and the Centers for Disease Control and Prevention (CDC) on the control of vaccine-preventable diseases. The ACIP produces a recommended schedule of adult immunizations by vaccine-preventable disease, age group, and indications based on several medical conditions such as pregnancy or chronic disease.

  • The ACIP recommends that healthy adults who want to reduce the risk of becoming ill with flu or transmitting it to others, receive an influenza (flu) vaccine each year. Yearly vaccination should begin in September or as soon as vaccine is available. Adults can be vaccinated throughout the influenza season into December, January, and beyond
  • The ACIP also recommends several other vaccinations for adults based on their age, medical conditions and/or other circumstances as determined by their physicians
  • As of July 2006, the average lifetime, private-sector cost to vaccinate healthy adults through age 74 with universally recommended vaccines is approximately $380 to $480, depending on the brand of vaccine given5

1.  Thompson WW, Shay DK, Weintraub E, et al. Mortality associated with ininfluenzaenza and respiratory syncytial virus in the United States. JAMA. 2003; 289:179-186.

2.  Thompson WW, Shay DK, Weintraub E, et al. Ininfluenzaenza-associated hospitalizations in the United States. JAMA. 2004; 292:1333-1340.

3.  National Center for Health Statistics. Health, United States, 2007, with chartbook on trends in the health of Americans. Hyattsville, MD: 2007.

4.  Molinari NA, Ortega-Sanchez IR, Messonnier ML, Thompson WW, Wortley PM, Weintraub E, Bridges CB. The annual impact of seasonal ininfluenzaenza in the US: measuring disease burden and costs. Vaccine. 2007; 25(27):5086-96. Epub 2007 Apr 20.

5.  Campbell KP, Lanza A, Dixon R, Chattopadhyay S, Molinari N, Finch RA, editors. A Purchaser’s Guide to Clinical Preventive Services: Moving Science into Coverage. Washington, DC: National Business Group on Health; 2006.