Percentage of fee-for-service (FFS) Medicare enrollees that had an annual flu vaccination. The 2023 County Health Rankings used data from 2020 for this measure.
Influenza is a potentially serious disease that can lead to hospitalization and even death. Every year there are millions of influenza infections, hundreds of thousands of flu-related hospitalizations, and thousands of flu-related deaths. An annual flu vaccine is the best way to protect against influenza and may reduce the risk of flu illness, flu-related hospitalizations, and even flu-related death.1 It is recommended that everyone 6 months and older get a seasonal flu vaccine each year, and those over 65 are especially encouraged because they are at higher risk of developing serious complications from the flu.2
Data and methods
Mapping Medicare Disparities Tool
The Centers for Medicare & Medicaid Services Office of Minority Health's Mapping Medicare Disparities (MMD) Tool contains health outcome measures for all states and counties for disease prevalence, costs, hospitalization for 55 specific chronic conditions, emergency department utilization, readmissions rates, mortality, preventable hospitalizations, and preventive services.
Key Measure Methods
Flu Vaccinations is a percentage
Flu Vaccinations is the percentage of fee-for-service Medicare enrollees that had a reimbursed flu vaccination during the year.
Flu Vaccinations is age-adjusted
Age is a non-modifiable risk factor, and as age increases, poor health outcomes are more likely. We report an age-adjusted rate in order to fairly compare counties with differing age structures.
This measure includes only the percentage of Medicare FFS enrollees who have received a flu vaccine and may potentially miss trends and disparities among younger age groups or people not enrolled in Medicare.
This numerator is the number of Medicare beneficiaries enrolled in fee-for-service Medicare Part B for at least one month of the selected year and who have received a covered influenza vaccine in the last year (Current Procedural Terminology/Healthcare Common Procedure Coding System codes: 90630, 90653-90657, 90660-90662, 90672-90674, 90685-90688, Q2035-Q2039, G0008).
The denominator is the number of Medicare beneficiaries enrolled in fee-for-service Medicare Part B for at least one month of the selected year. Individuals enrolled in Medicare Advantage at any point during the year are excluded.
Can This Measure Be Used to Track Progress
This measure can be used to track progress with some caveats. This measure was first included in the 2019 Rankings, but trend graph data can be used to track progress.
Finding More Data
Disaggregation means breaking data down into smaller, meaningful subgroups. Disaggregated data are often broken down by characteristics of people or where they live. Disaggregated data can reveal inequalities that are otherwise hidden. These data can be disaggregated by:
Flu vaccination data by age groups, sex, and race can be obtained from the Mapping Medicare Disparities tool.
1 Key Facts About Seasonal Flu Vaccine. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/prevent/keyfacts.htm Published: Feb 2020. Accessed: March 3, 2020.
2 Flu & People 65 Years and Older. Center for Disease Control and Prevention. https://www.cdc.gov/flu/highrisk/65over.htm. Published: May 6, 2021. Accessed: July 23, 2021.