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Byung-Kwang Yoo, MD, PhD, Megumi Kasajima, BS, Kevin Fiscella, MD, MPH, Nancy M. Bennett, MD, Charles E. Phelps, PhD and Peter G. Szilagyi, MD, MPH

Byung-Kwang Yoo, Megumi Kasajima, and Charles E. Phelps are with the Department of Community and Preventive Medicine, School of Medicine and Dentistry, University of Rochester, Rochester, NY. Kevin Fiscella is with the Department of Family Medicine, School of Medicine and Dentistry, University of Rochester, Rochester. Nancy M. Bennett is with the Department of Medicine, School of Medicine and Dentistry, University of Rochester, Rochester. Peter G. Szilagyi is with the Department of Pediatrics, School of Medicine and Dentistry, University of Rochester, Rochester.

Correspondence: Correspondence should be sent to Byung-Kwang Yoo, MD, PhD, Division of Health Policy and Outcomes Research, Department of Community and Preventive Medicine, University of Rochester, School of Medicine and Dentistry, 601 Elmwood Avenue, Box 644, Rochester, NY 14642 (e-mail: Byung-Kwang_Yoo{at}urmc.rochester.edu). Reprints can be ordered at http://www.ajph.org by clicking on the "Reprints/Eprints" link.

Objectives. We assessed short-term responsiveness of influenza vaccine demand to variation in timing and severity of influenza epidemics since 2000. We tested the hypothesis that weekly influenza epidemic activity is associated with annual and daily influenza vaccine receipt.

Methods. We conducted cross-sectional survival analyses from the 2000–2001 to 2004–2005 influenza seasons among community-dwelling elderly using the Medicare Current Beneficiary Survey (unweighted n = 2280–2822 per season; weighted n = 7.7–9.7 million per season). The outcome variable was daily vaccine receipt. Covariates included the biweekly changes of epidemic and vaccine supply at 9 census-region levels.

Results. In all 5 seasons, biweekly epidemic change was positively associated with overall annual vaccination (e.g., 2.7% increase in 2003–2004 season) as well as earlier vaccination timing (P < .01). For example, unvaccinated individuals were 5%–29% more likely to receive vaccination after a 100% biweekly epidemic increase.

Conclusions. Accounting for short-term epidemic responsiveness in predicting demand for influenza vaccination may improve vaccine distribution and the annual vaccination rate, and might assist pandemic preparedness planning.