History and Mission

For the past ten years, the Boston Coalition for Adult Immunization (BCAI) has developed and implemented an innovative model centered on teaching and training medical/nursing students about the influenza virus and how to administer influenza vaccine to underserved populations. Through the years, the program has proven to be a unique and valuable service to the community in protecting at-risk individuals from unnecessary deaths and emergency room visits and/or hospitalizations and their attendant cost. The program has also afforded the opportunity to provide hundreds of students annually with real world, community health experience early in their professional training.

Key Achievements

  • Improved coordination of community-based clinics and community education, particularly in underserved areas of the City, i.e. Roxubry, Mattapan, Dorchester
  • Provided education and flu clinics at over 60 community sites annually
  • Annually, recruited over 250 first and second year medical students to participate in trainings
  • Held dual pneumococcal and flu clinics at some community sites
  • Recruited physicians as volunteers to work and mentor with medical students at flu clinics
  • Increased the number of influenza vaccines given by students from 1,400 to over 7,000
  • Broadened the education and value of flu shots among at-risk underserved constituents


  • According to a 2012 CDC report, Influenza and Pneumonia became the 8th leading cause of death replacing kidney disease.
  • 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

The Future

The success of this model program over the past ten years is evident in the number of committed collaborative partners (over 30 including hospitals, medical/nursing schools, community health centers/organizations, and state agencies not including over 60 clinical sites) in this effort. Through the years, the organization has struggled with mixing the right ingredients of personnel, volunteers, mentors and financial resources to implement its mission. With the continuing disparity in healthcare access for underserved populations and the ongoing threats of an imminent pandemic this program has never been so critical. We believe this is a model program and continue to develop innovative student training materials, outcome surveys and analysis for tracking. With increased capacity and the participation and commitment of the medical students this program has exceptional potential for replication.

October 11, 2012
Primary teaching affiliate
of BU School of Medicine