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Executive Summary

Every year, hundreds of elders and other vulnerable individuals die unnecessarily from the flu or complications caused by the influenza virus. For the past ten years, the Boston Coalition for Adult Immunization has been developing an innovative model centered on teaching and training medical/nursing students about the influenza virus and how to administer influenza vaccine to underserved populations. In addition, one of the nation’s health objectives for 2010 is to achieve 90% coverage of noninstitutionalized adults aged 65 or older for both influenza and pneumococcal vaccinations. In 1996, Ms. Bissonnette, Director of the Boston Coalition for Adult Immunization and Patrick O’Reilly, Assistant Director of Education and Evaluation at the Massachusetts Peer Review Organization (MassPro), recognized that there were a a number of agencies across the City of Boston involved in adult immunization efforts but their work was uncoordinated. There was also a need to extend access to flu immunizations.

BCAI’s Innovative Education and Training Model

For the past ten years, the Boston Coalition for Adult Immunization has been developing an innovative model centered on teaching and training medical/nursing students about the influenza virus and how to administer influenza vaccine to underserved populations. It now includes representatives from hospitals, government agencies, neighborhood health centers, private agencies, and nursing, public health, and medical schools. Through the years, the program has proven to be a unique and valuable service to the community as it avoids unnecessary deaths and emergency room visits and/or hospitalizations and their cost, as well as educating hundreds of students.

Closing the Gap in Immunization Disparity Among the Underserved and Most Vulnerable

In Boston there are approximately 63,000 individuals over the age of 65. Of these, 20.1% are living below the poverty line (U.S. Census
Bureau), a population considered underserved by traditional health programs. The target population for this program includes low income, isolated elders, homeless adults in shelters, food kitchens and other settings, developmentally challenged adults in half way houses and church members in the ethnic and minority communities of Boston (mainly persons of color who have traditionally refused immunization), Vietnamese, Russian, Cape Verdean, American Indians and other immigrant populations.

U.S. Census Bureau, 2005-2009 American Community Survey

The Need

  • Depending on circulating strains and population preparedness, influenza accounts for anywhere from 3,000 – 49,000 deaths/year
    in the US (CDC) and from 250,000 – 500, 000 deaths worldwide (WHO).  These numbers show the extreme variability of the length of the peak flu season, the virus’s level of severity and its ability to produce new infective strains yearly.  On average, about 200,000 hospitalizations are related to influenza every year in the United States. (CDC)  Although this number fluctuates, it is steadily increasing as the elderly population increases.  The CDC reports that older adults comprise 90% of reported deaths that occur on average each year from influenza complications.
  • CDC estimates that, for each additional million elderly persons vaccinated, approximately 900 deaths and 1,300 hospitalizations would
    be averted during the average influenza season. The number of deaths and the cost to society are likely to increase as the nation’s population ages.
  • The U.S. Census Bureau projects the number of adults ages 65 or more will double from 35 million (or 13 percent of the population) in
    2000 to 70 million (or 20 percent of the population) by 2030.
  • According to the Centers for Disease Control, between 15% and 35% of the U.S. population could be affected by an influenza pandemic, and the economic impact could range between $71.3 and $166.5 billion.
  • CDC.  Influenza Associated Deaths.  http://www.cdc.gov/flu/about/disease/us_flu-related_deaths.htm.
  • CDC.  Influenza Associated Hospitalizations. http://www.cdc.gov/flu/about/qa/hospital.htm.
  • World Health Organization. http://www.who.int/mediacentre/factsheets/fs211/en/index.html
  • Contact|Directory|BUMC
    March 29, 2012
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    of BU School of Medicine