Who is at risk for influenza? Using criteria other than age

Colorado Access is a safety-net managed care organization that serves the medical and behavioral needs of the medically underserved. Because 75 percent of our population is children, we have had difficulty defining criteria to determine who is at risk for influenza and thus should receive an annual influenza vaccination. Our objective was to create a comprehensive list of diagnostic codes to be used to identify these high-risk individuals, using criteria other than age.

A task force of medical experts familiar with diseases and chronic conditions associated with influenza and pneumonia convened to determine criteria other than age that can be used to identify populations recommended to receive an annual influenza vaccination. The task force used previously published criteria, compared them to the Advisory Committee on Immunization Practices (ACIP) recommendations, and developed a single, comprehensive diagnostic-criteria list that correlates with the ACIP recommendations, defined by ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification, Fifth Edition) codes, to identify populations recommended to receive an annual influenza vaccination.

A comprehensive list of ICD-9 codes that indicate diagnostic criteria to be used to define populations at risk for influenza according to the ACIP recommendation was developed.

Colorado Access found that having criteria to target groups recommended to receive an annual influenza vaccine facilitates the planning of preventive health programs. These criteria may be beneficial to other health plans and agencies that promote flu vaccination.