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Adult vaccine coverage called 'unacceptably low'


 

FROM MORBIDITY AND MORTALITY WEEKLY REPORT

Far too few U.S. adults are getting vaccinated against diseases other than flu, according to data from the Centers for Disease Control and Prevention’s National Health Interview Survey.

Although there is a heightened awareness about childhood and flu vaccinations, "we want adults to be aware that there are other vaccines that can prevent other serious diseases, such as whooping cough and shingles," Dr. Howard Koh, assistant secretary for health at the Department of Health and Human Services, said during a press briefing on the report.

The survey data showed that vaccination rates for tetanus-toxoid containing vaccines (Tdap and/or Td) and human papillomavirus (HPV) improved slightly between 2010 and 2011, but that, overall, rates of adult immunizations were still well below targets set by Healthy People 2020.

Describing the low vaccination rates as a "broad public health challenge," Dr. Koh called on doctors to regularly review vaccine schedules with their patients.

The report also highlights racial disparities in vaccination rates. While whites had the highest rates of vaccination, Hispanics, Asians, and blacks fell behind. The disparities could be caused by lack of access and cultural and linguistic barriers, officials said.

Dr. Koh said that the Affordable Care Act, which will extend health coverage to millions more Americans when its state health insurance exchanges start up in 2014, "is critically important ... because it makes preventive care more affordable."

Dr. Koh also unveiled the new HealthMap Vaccine Finder, where patients can find vaccine providers by zip code; he encouraged physicians to register on the site.

The report analyzed data from the 2011 NHIS for pneumococcal vaccine, tetanus toxoid–containing vaccines, hepatitis A, hepatitis B, herpes zoster, and HPV vaccines.

The highest vaccination rate increase was seen in HPV vaccination among women 19-26 years old (9%). In 2011, 30% of women in this age group reported having received the vaccine, compared with roughly 21% in 2010 (MMWR 2013;62[Early Release]:1-7).

In 2011, 13% of adults 19-64 years were vaccinated with Tdap, a 4.3% increase from 2010. However, the proportion of adults in all age groups receiving any tetanus toxoid–containing vaccines (Td or Tdap) has not changed over the past decade.

Pneumococcal vaccination coverage among adults aged 19-64 years was roughly 20%, a 1.6% increase from 2010. Among adults 65 years or older, the coverage was 62%, reflecting a 2.6% increase from 2010.

Between 2010 and 2011, overall hepatitis A vaccination coverage increased among adults between 19-49 years by 1.8% but was still low (13%), according to the report.

Herpes zoster vaccination rates remained similar to 2010, at roughly 16%.

"Vaccination coverage levels among adults are unacceptably low. Substantial improvement in adult vaccination is needed to reduce the health consequences of vaccine-preventable diseases among adults," the authors wrote.

They suggested education, increased access to vaccination services, and efforts to remove administrative and financial barriers to vaccination as potential solutions.

The report has several limitations, the authors noted. The NHIS sample excludes individuals in the military or in institutions, leading to possible under- or overestimation of vaccination rates. Also, the survey response rate was 66%, which could lead to sampling bias. The vaccination status wasn’t validated by medical records, and self-report is subject to recall bias. The authors added that the Tdap estimate is subject to considerable uncertainty.

n.miller@elsevier.com

On Twitter @naseemsmiller

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