Abstract
For many years, Swedish health authorities have recommended yearly influenza immunization to persons in medical risk groups and to people aged 65 years and older. Despite this recommendation, the vaccination coverage has been lower than 50% in Jonkoping County, as in all other counties of Sweden. To increase the rate of influenza immunization in Jonkoping County, we established a multiprofessional action group and designed a primary health care-based program. Important elements in the project were free of charge vaccination; an education program targeting primary health nurses; mass media information through advertisements in newspapers, local TV, posters, and handouts; and instituting and implementing a computerized registry with easy access to summary statistics by which each unit could compare its achievements with others. Personal invitation letters were not used because of economical reasons. The vaccination was performed in the county's health centers and to lesser extent in the hospitals. Most of the health centers are owned and run by the county council. A few health centers are private but have contract with the county council. Economical incentives to the providers were not used. During a 4-year period, the immunization rate among all inhabitants of the county aged 65 years increased from 45% to 70%. All the 13 municipalities in the county increased their vaccination rate; their recent figures vary between 61% and 74%. The vaccination rate among people aged 65 years in Jonkoping County is now the highest in Sweden, but still not as high as in some other European countries. Our influenza immunization campaign can act as an example for other healthcare providers.