WASHINGTON Approximately half of 1,005 American adults surveyed by the National Foundation for Infectious Diseases said that they were unconcerned that either they or a family member will become infected with a vaccine-preventable disease, despite the fact that more than half a million U.S. adults die each year from such diseases, reported Dr. Kristin L. Nichol, who presented the survey findings at a press conference.
"Americans don't know much about the vaccines available to protect them, and they have too little concern about getting these diseases," said Dr. Nichol, who serves as chairwoman of the advisory committee of the National Coalition for Adult Immunization.
"Another interesting but not too surprising finding was that most people say they would get a vaccine if their doctor recommends it," said Dr. Nichol, a professor of medicine at the University of Minnesota, Minneapolis. Specifically, 87% of the survey respondents said they would be either "somewhat likely" or "very likely" to get a vaccine based on a doctor's recommendation.
Although 49% of the respondents could name influenza as a vaccine-preventable illness, awareness dropped drastically for other vaccine-preventable illnesses, ranging from 18% who named pneumonia to only 3% who named acellular pertussis and meningitis.
Adult vaccinations should be part of the overall discussion of wellness, along with nutrition, physical activity, and preventive screenings, said Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention in Atlanta.
Dr. Schuchat presented data from a first-time survey of immunization coverage in adults. "We have a long way to go to reach the targets that we have set for the nation," she said.
A National Immunization Survey was conducted of approximately 7,000 adults aged 18 and older in the summer of 2007. The survey respondents were selected at random and contacted by phone, similar to the annual survey of childhood vaccination conducted by the CDC and other agencies.
Overall, 69% of adults aged 65 years and older said they had received a flu vaccination during the 20062007 flu season. In addition, 66% said they had received pneumococcal vaccinations, and 44% said they had received a tetanus shot within the past 10 years.
Coverage was especially low for two newly licensed vaccines, Dr. Schuchat said. The Tdap vaccine, which is recommended for adults aged 1864 years to prevent tetanus, diphtheria, and acellular pertussis was licensed in 2005, but only 2% of the survey respondents reported that they had received this vaccine.
Similarly, approximately 2% of the respondents said that they had received the shingles vaccine, which was licensed in 2006 and approved for adults aged 60 years and older.
Approximately 10% of the female respondents said that they had received at least one of the three-dose series of the HPV vaccine to prevent cervical cancer, which was licensed in 2006 and approved for girls and women aged 926 years.
"We need doctors and nurses and health care providers to know about these new tools and to take advantage of them themselves," Dr. Schuchat said.
Flu vaccination among health care workers currently averages about 42%, she noted.
Through its part B, Medicare covers the pneumococcal polysaccharide vaccine, the influenza vaccine, and (for high-risk adults) the hepatitis B vaccine, and it covers most other adult vaccinations through part D, including the shingles vaccine. It is important to remind adult patients that many vaccinations are covered by insurance, Dr. Schuchat said.
Younger adults often have insurance coverage for preventive vaccines, Dr. Schuchat added. She cited a recent survey of insurance companies in which more than 90% covered the influenza and pneumococcal vaccines and most covered at least five vaccines for adults. "We strongly encourage insurance companies to cover vaccines, because they are cost effective and keep you healthy," she said.
Finding time to coordinate adult vaccination presents another challenge. "If we are going to try to improve immunization rates in the physician practice, it needs to be a team effort," said Dr. Robert H. Hopkins Jr., an internal medicine physician and pediatrician at the University of Arkansas, Little Rock.
He suggests increasing in-office adult vaccination by having nurses ask patients about their vaccination status and by providing flyers in the office to educate patients about the preventive vaccines that are recommended for them.
In addition, consider alternative settings for vaccinations, such as pharmacies or workplaces, suggested Dr. Hopkins, who also serves as governor of the Arkansas chapter of the American College of Physicians. "But we need to make sure that the information gets back to the health care provider so we can continue to coordinate care," he emphasized.