KEYWORDS:
adult, high-priority, flu, Medicaid

BACKGROUND:
The Medical Care Coordination and Case Management Branch (MCCCM) of the California Department of Health Services (CDHS) uses home health nurses to provide case management services to over 5,000 Medi-Cal beneficiaries with chronic and catastrophic diseases each year. Since this population fits the criteria for receiving a flu vaccination, it is appropriate to direct efforts at enhancing immunization coverage among these individuals. Currently, there is little information regarding flu immunization coverage in this population group.

OBJECTIVE:
To assess immunization coverage among persons at high risk for influenza disease complications during the 2000-2001 and 2001-2002 flu seasons.

METHOD:
A telephone survey was conducted by MCCCM to determine flu coverage during the 2000-2001 flu season among MCCCM patients over the age of 2 years from August through September 2001. In September 2001, CDHS sent a mailing promoting influenza vaccination to these beneficiaries, their physicians, and the home health agencies caring for these patients. A telephone survey was conducted in January-April 2002 to assess immunization coverage during the 2001-2002 flu season.

RESULT:
A total of 1,242 beneficiaries responded to both telephone surveys. The age distribution of the sample is as follows: 50% in less than 19 yrs category, 28% in 19-49 yrs category, and 22% in greater than 50 yrs category. In the 2000-2001 flu season, 50% of the beneficiaries reported receiving a flu shot compared to 62% in 2001-2002 flu season.

CONCLUSION:
National estimates for flu immunization coverage in high-risk populations (under 65 years of age) indicate coverage well below the Healthy People 2010 goal of 60%. This study shows that flu immunization coverage is higher than expected among this population, most likely due to the close follow-up provided by case management.

LEARNING OBJECTIVES:
To describe flu immunization coverage in a recommended high-priority group during the 2000-2001 and 2001-2002 flu seasons.