Germy Wormy® was invented by Margaret Back because she was sick of being sick from her pre-school child and was desperate to find a way to keep the germs down.
Then, in Mar 2006, later in life than she would have liked, she learned about the concept of coughing and sneezing into your elbow from the American Academy of Pediatrics and CDC websites.
Google "cough into elbow". You will be surprised at how many hits there are advocating this approach.
Her first reaction was - where the heck have I been, I didn't know about this. The second reaction was - why didn't anyone tell me?
At that point, she was a mom on a mission - to teach her daughter to cough and sneeze into her elbow. But, it was hard to teach her daughter to do it and it got her daughter's shirt dirty. So she invented a way to teach her daughter and keep her sleeves clean. A few years, lots of gray hair and a lot of learning later, the Germy Wormy Germ Smart for Kids Program and Disposable Sleeve was launched in November 2008.