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Epidemiological Facts Concerning Adult Immunization
- In the U. S., vaccination efforts have decreased deaths due to childhood vaccine-preventable diseases to less than 500 per year. In contrast, during an average year, nearly 50,000 adults die from diseases that are preventable through vaccination. Approximately 36,000 adults die from influenza, over 6,000 from invasive pneumococcal disease, and 5,000 from hepatitis B.
Influenza Vaccination Coverage
Data from the 2006 and 2007 National Health Interview Surveys (NHIS) and the Behavioral Risk Factor Surveillance System (BRFSS) surveys indicate that influenza vaccination coverage among adults for the 2006--07 season was 26% -- 35.1% among persons aged 18--49 years with high-risk conditions, 36%--42.0% among all persons aged 50--64 years, and 66%--72.1% among all persons aged >65 years.
However, vaccination coverage remained well below Healthy People 2010 targets. Increasing influenza vaccination coverage among adults in the United States will require more cooperation among health-care providers, professional organizations, vaccine manufacturers, and public health departments to raise public awareness about influenza vaccination and to ensure continued distribution and administration of available vaccine throughout the vaccination season.
For a more detailed discussion of coverage levels among specific groups, beliefs and attitudes toward influenza vaccination, and strategies to increase vaccination rates, see Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practices (ACIP), Morbidity and Mortality Weekly Report, August 8, 2008, Vol. 57/No. RR-7, pp. 22-24. http://www.cdc.gov/mmwr/pdf/rr/rr5707.pdf
For more information about the 2006 and 2007 Behavioral Risk Factor Surveillance System (BRFSS) surveys, see State-Specific Influenza Vaccination Coverage Among Adults --- United States, 2006--07 Influenza Season, Morbidity and Mortality Weekly Report, September 26, 2008 / 57(38);1033-1039. http://www.cdc.gov/mmwr/PDF/wk/mm5738.pdf
Click here for more information about the Healthy People 2010 Objectives:
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- Hepatitis B virus (HBV) infections cause 80% of hepatocellular carcinomas. Annually 4,000-5,000 persons die from HBV-induced chronic liver disease and primary hepatocellular carcinoma.
Although HBV infection is uncommon among adults in the general population, it is highly prevalent in certain groups. The following table shows the risk of acquiring HBV infection in certain populations.
| Population Group |
Prevalence of Serologic Markers of HBV Infection |
| |
HBsAg(%) |
All Markers (%) |
| HIGH RISK |
|
|
| Immigrants/refugees from areas of high HBV endemicity. |
13 |
70-85 |
| Clients in institutions for the developmentally disabled. |
10-20 |
35-80 |
| Users of illicit parenteral drugs. |
7 |
60-80 |
| Homosexually active men. |
6 |
35-80 |
| Patients of hemodialysis units. |
3-10 |
20-80 |
| Household contacts of HBV carriers |
3-6 |
30-60 |
| INTERMEDIATE RISK |
|
|
| Prisoner (male). |
1-8 |
10-80 |
| Health care workers-frequent blood contact. |
1-2 |
15-30 |
| Staff of institutions for the mentally retarded. |
1 |
10-25 |
| Heterosexuals with multiple partners. |
0.5 |
5-20 |
| LOW RISK |
|
|
| Health care workers-no or infrequent blood contact. |
.3 |
3-10 |
| Healthy adults (first time volunteer blood donor's). |
.3 |
3-5 |
Source: Epidemiology and Prevention of Vaccine Preventable Diseases (the Pink Book), Centers for Disease Control and Prevention, 10th Edition, 2nd printing, 2008, p. 218.
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- A large percentage of physicians who believe they recommend influenza or pneumococcal vaccination for their patients 65 and older do not actually offer vaccine to those patients.
Results displayed in the graph show the proportion of physicians who stated that they recommend influenza or pneumococcal vaccination for their patients 65 and older (beliefs) versus the percent of time they actually offered vaccine to those patients (practice).
Adapted from Herman CJ, Speroff T, Cebul RD. Improving compliance within the older adult: results of a randomized cohort study. JAGS 1994;42:1154-1159.
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- During most influenza seasons, 10% to 20% of the nation’s population is infected with influenza with an annual estimated cost of approximately $10 billion.
During most influenza seasons, 10% to 20% of the nations population is infected with influenza with an annual estimated cost of approximately $10 billion. During severe epidemics, estimated cost may be as high as $12 billion.
Source: Williams WW, Hickson MA, Kane MA, Kendal AP, Spika JS, Hinman AR. Immunization policies and vaccine coverage among adults: the risk for missed opportunities. Ann Intern Med 1988;108:616-625.
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- A physician’s recommendation is the most important reason why people get vaccinated. Even those with negative attitudes about vaccinations will accept vaccination upon their physician’s advice. Low vaccination rates among adult patients represent missed opportunities to vaccinate during health care visits.
- Each year in the U.S., pneumococcal disease accounts for over 100,000 hospitalizations for pneumonia.
Each year in the U.S., pneumococcal disease accounts for over 100,000 hospitalizations for pneumonia. As many as 35% of pneumococcal isolates may have intermediate or high-level resistance to penicillin; many of these isolates are also resistant to other antimicrobial drugs, thus complicating the management of pneumococcal infection. Such emerging antimicrobial resistance further emphasizes the need for preventing pneumococcal infection.
Source: Fact Sheet on Streptococcus pneumoniae Disease. Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, CDC. The Fact Sheet may be accessed at: http://www.cdc.gov/ncidod/dbmd/diseaseinfo/streppneum_t.htm.
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- Most tetanus cases occur in adults 60 years of age and older.
CDC's National Notifiable Disease Surveillance System collected data on physician-diagnosed cases of tetanus. During 1998-2000, an average of 43 cases of tetanus was reported annually; the average annual incidence was 0.16 cases/million population. The highest average annual incidence of reported tetanus was among persons aged 60 years and older (0.35 cases/million population), persons of Hispanic ethnicity (0.37 cases/million population), and older adults known to have diabetes (0.70 cases/million population).
The majority of tetanus cases occurred among persons inadequately vaccinated or with unknown vaccination history who sustained an acute injury. Adults aged 60 years and older were at highest risk for tetanus and tetanus-related death.
Source: "Tetanus Surveillance--United States, 1998-2000, MMWR Surveillance Summaries," MMWR, June 20, 2003, Vol. 52, No. SS-3. To obtain a copy of the surveillance summary, go to: www.cdc.gov/mmwr/PDF/ss/ss5203.pdf
Source: Data from the National Notifiable Disease Surveillance System, CDC, Atlanta, GA.
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- Influenza and pneumonia are the 8th leading cause of death for all age groups and constitute the 7th leading cause of death in persons 65 and older.
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