Flu Vaccinations

Percentage of fee-for-service (FFS) Medicare enrollees that had an annual flu vaccination.

The 2022 County Health Rankings used data from 2019 for this measure.

Reason for Ranking

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 help 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]

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.

Measure limitations

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.

Data Source

Years of Data Used


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.

Digging Deeper
Subcounty Area0

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.

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When it comes to developing and implementing solutions to problems that affect communities, evidence matters. The strategies below give some ideas of ways communities can harness evidence to make a difference locally. You can learn more about these and other strategies in What Works for Health, which summarizes and rates evidence for policies, programs, and systems changes.

Implement multi-component efforts that include coordination of health services by multidisciplinary teams of health care professionals, patient self-management, and patient education
Provide continuous, comprehensive, whole person primary care that uses a coordinated team of medical providers across the health care system

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