Evaluation of a legislatively mandated influenza vaccination program for adults in Rhode Island, USA

There have been disruptions in influenza vaccine supply in the United States during the 2000-2001, 2001-2002, 2004-2005, and 2005-2006 influenza seasons. Some providers received limited or no vaccine, while others obtained their order in full, depending on with whom the order was placed. A state law was passed that mandates the Rhode Island Department of Health to include the purchase and distribution of influenza vaccine for adults in its immunization program.

To evaluate the first 2 years of the statewide adult influenza immunization program.

We conducted key informant interviews of 25 providers in 2008 and surveyed all enrolled providers in 2008 (year 1) and 2009 (year 2).

State of Rhode Island.

Physician practices and facilities that provide influenza vaccination to adults, including private practices, nursing homes, health centers, urgent care facilities, hospitals, mass immunizers, and businesses.

Enrolled providers received influenza vaccines free and billed insurers, Medicare, and Medicaid for vaccine administration costs.

Provider satisfaction with different program components and overall satisfaction.

For year 1, there was higher satisfaction with enrollment, training, vaccine ordering, and vaccine shipment than with paperwork and claims. Of the survey respondents, 71% reported that the program paperwork was reasonable and 30% reported difficulties in receiving reimbursement. Satisfaction with the vaccination start date of October 17, 2007, was 80%. There was high overall satisfaction (94%). In response to streamlining of reporting requirements and setting an earlier start date of October 7, 2008, for year 2, there was a significant increase in satisfaction with paperwork (89%) and with vaccination start date (90%).

The findings may be useful in guiding the development of vaccination programs to provide influenza and other vaccines for adults at the state or national level.