Zoster, Pneumococcal and Influenza Vaccine Assessment of Meals-on-Wheels Recipients

Background: Because Meals-on-Wheels recipients are generally elderly, low-income, in compromised health and restricted in mobility they are at risk for complications from influenza, pneumococcal and shingles.  This is a hard-to-reach and vulnerable group.  However, assessment through the already established Meals-on-Wheels delivery system is capable of determining recipients’ influenza, pneumococcal and zoster vaccine attitudes and coverage levels, and of providing education and intervention.   

Setting: Adult immunization coalition, state and local immunization programs and aging services.

Population: Meals-on-Wheels recipients statewide.

Project Description: A survey was initially developed for distribution through the Meals-on-Wheels delivery system which assessed the recipients’ desire to receive influenza vaccine and need for help obtaining vaccination.  In 2008/2009, the survey was expanded to include zoster and pneumococcal vaccines and distributed with educational fact sheets.  In 2009, a zoster project using ARRA funding allowed for vaccine to be provided to uninsured adults for only a capped administration fee.  Outreach flyers promoting this vaccine were distributed to Meals-on-Wheels recipients in one urban and one rural district.  In 2010, the vaccination survey and fact sheets were revised slightly and redistributed statewide.             

Results/Lessons Learned: From nine of twelve districts, 1,120 of the 2008/2009 surveys were returned (approximately 24%). Results indicated that influenza and pneumococcal rates for Meals-on-Wheels recipients exceeded BRFSS rates and the statewide zoster rate was 7%.  To date, 1,148 of the 2009/2010 surveys from nine districts have been returned, including those from the urban and rural districts where ARRA vaccine flyers were distributed.  Preliminary results indicate that coverage is only slightly above the BRFSS rates for influenza and pneumococcal, but zoster coverage has risen to 10% statewide.  In the urban district where the flyer was distributed zoster coverage almost doubled, and in the rural district coverage more than tripled.