Adults Fall Short on Vaccinations

Some Adult Vaccination Rates Are Up, but Experts Say There's Room for Improvement

Vaccinations aren't just for kids. Adults need them, too, and while vaccination rates are increasing, there's definitely room for improvement, according to public health experts.
At a news conference today hosted by the National Foundation for Infectious Diseases (NFID), experts released new CDC data, spelled out areas that need improvement, and discussed how to be proactive at the doctor's office.
Thanks to vaccines, ''we see only a fraction of the disease, death and suffering'' as in years past, says Susan J. Rehm, MD, the medical director of the NFID who opened the news conference. "But there are lower vaccination rates in adults," she says. "Skipping your vaccines is not all about you, it's about people around you. We are talking about preventable illness and preventable death."
At the conference, the CDC released new data on 2009 adult vaccination coverage. ''For most adults, coverage isn't as high as we'd like it to be," says Melinda Wharton, MD, MPH, deputy director of the National Center for Immunization and Respiratory Diseases.
The trends toward vaccination are going up, she says, which she praised. But in many cases, the vaccine coverage doesn't meet the goal for the Healthy People 2010 targets set up by public health officials.
For instance, in 2009:

• Influenza vaccine coverage was 40.1% for adults ages 50-64 and 33.4% for adults 19-49 deemed at high risk. Adults 65-plus did better, with nearly 66% of them getting the vaccine.
• About 60% of adults 65-plus got the pneumococcal vaccine to protect against pneumonia, up from about 50% in 1999. Just 10% of adults 60 and up got the recommended vaccine against shingles.
• Hepatitis B vaccination coverage increased, especially among adults ages 19 to 49 at high risk for infection (such as men who have sex with men; those with multiple sex partners, past or present). About 42% of this age range was covered by the vaccine in 2009, compared to about 38% in 1999.
• Tetanus vaccination remained stable over the past 10 years, with nearly 69% of non-Hispanic whites 19 to 49, for instance, getting the shot and lower percentages in other ethnic groups. When it came to the newly licensed Tdap, which includes protection against whooping cough or pertussis, of adults ages 19 to 64 who got a tetanus vaccine since 2005 and knew if they got the one with the pertussis, just 50.8% reported getting Tdap.

Why the Low Adult Vaccination Rates?

In an NFID-commissioned survey of 300 doctors conducted online and 1,000 adult consumers conducted by telephone, Rehm says they found ''disconnects'' between input from the two groups.
For instance, while a high percent of doctors say they usually broach the topic of vaccines, consumers tend to report they bring it up.
''Eighty-seven percent of physicians say they discuss vaccines with every patient who comes into their office," Rehm says.
''But when we talked to consumers, nearly half, 47% say they don't recall ever discussing vaccines other than influenza with their health care provider or doctor."
What does work to convince adults to get vaccinated? A recommendation from the doctor, apparently. "Nearly nine in 10 of the adults we surveyed said a strong recommendation for the doctor would motivate them," Rehm says.
A little education may help, too, she says. "Only half of American adults are aware there is a formal schedule of immunizations applicable to them."

Why Get Vaccinations?

Other public health care experts speaking at the conference gave convincing arguments for why adults need to pay more attention to vaccinations.
Jeffrey Cohen, MD, chief of the medical virology section and laboratory of infectious diseases at the National Institute of Allergy and Infectious Disease, told the story of his father, who contracted shingles.
Adults 60 and over are advised to get a shingles vaccination because varicella zoster virus, the same virus that causes chickenpox, can also reactivate decades later to cause herpes zoster, or shingles.
The painful skin eruption is common among older adults and can lead to chronic pain that lasts for months or years.
"When he developed shingles, it profoundly changed his life," Cohen says. Formerly a bank manager, he worked long hours and loved chatting with customers. "After he developed shingles, he developed a long-lasting pain that sometimes occurred even after the rash was resolved. When he recovered a year later, he confided in me that he had actually considered suicide and that he wouldn't wish it on his worst enemy."
Other experts stress the importance of the flu vaccine.
"Many people dismiss the flu as a minor annual nuisance," says Catherine Alicia Georges, RN, EdD, a member of the AARP board of directors and professor and chair of nursing at the Lehman College and Graduate Center at City University of New York who also spoke at the conference.
In actuality, she says, complications from flu contribute to some 200,000 hospitalizations each year, she says. "The flu can be deadly."