Most adults are not vaccinated even though there are vaccines available to prevent serious disease
PREVENTION: ADULT IMMUNIZATION
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Efforts to offer proactive protection through the childhood vaccination program have been a great success. The current challenge is to extend that success to the adult population.

The Difference We Can Make

  • Each year, between 40,000 and 50,000 adults die from vaccine-preventable diseases; more than from breast cancer, prostate cancer, colorectal cancer, suicide, HIV, or car wrecks.1
    • The flu is extremely unpredictable. Each year from 1976 to 2007, a range of 3,000 to 49,000 Americans died from influenza.1
    • In addition, influenza is responsible for 200,000 hospitalizations each year.1
  • Approximately 5,000 people each year die from pneumonia2, and more than 1 million adults get shingles each year.3

Most adults are not vaccinated even though there are vaccines available to prevent serious disease.

The following table highlights the low rate of vaccination among adults with just a few vaccines that are known to reduce health risks and save lives.

To find out what vaccines are recommended for adults, take this quiz on the CDC website.

Failure to vaccinate is expensive.

Flu alone results in more than $87 billion of US economic burden annually (hospitalization costs, missed days of work, lost lives, etc.).8 Influenza vaccination for adults is cost saving relative to treating the disease. On average, people with Influenza-like Illness (ILI) were sick for about 8 days, missed about 1.5 days of work and worked at least 4 days with reduced effectiveness. Also, 31% of people with ILI visited a healthcare provider, and 24% received antibiotics.9

  • Adults with pertussis or whooping cough may undergo extensive medical evaluation, miss work and possibly pass the disease on to young children who are at most risk of complications from whooping cough.10
  • An outbreak of whooping cough in the summer of 2010 in California has resulted in 9 infant deaths and over 4,000 cases. This is more than any other year since 1955.11
  • A study in the VA Health System showed that when vaccination rates for influenza went from 27% to 70% and for pneumococcal from 28% to 85%, pneumonia hospitalization rates decreased by 50%, and the healthcare system saved $117 for each vaccine administered.12

What We Need to Achieve

Adult vaccination along with other prevention services is a key component of healthcare reform.

By including adult vaccination as a part of a basic patient-centered prevention health benefits package we can improve health, save lives, and reduce costs.

What We Need to Change

Vaccine reimbursement for many with health insurance is unclear or inadequate. Public programs and funding are insufficient for the target population. Healthcare reform legislation includes immunization as a preventive service without cost-sharing. This vital service should be promoted and implemented to help protect adults from vaccine-preventable diseases.

Provide better infrastructure for adult immunization.

Frequently adults do not make regular preventive health visits, and there is limited use of alternative sites for vaccinations, such as pharmacies.

Unlike well-established pediatric vaccination quality improvement measures, there are not comprehensive measures for adult immunization.

References:
  1. Centers for Disease Control and Prevention. Questions & Answers: Seasonal Influenza (Flu): The Disease. Centers for Disease Control and Prevention Web site. Available at www.cdc.gov/flu/about/qa/disease.htm. Accessed November 9, 2010.
  2. Facts About Pneumococcal Disease. National Foundation of Infections Diseases. Available at http://www.nfid.org/pneumococcal/consumers_factsheet.html. Accessed on October 1, 2010.
  3. Harpaz R et al. Prevention of Herpes Zoster. Recommendations of the Advisory Committee on Immunization Practices (ACIP). 2008;57(05);1-30.
  4. National Foundation of Infectious Diseases. Available at http://www.nfid.org/pdf/factsheets/adultfact.pdf. Last accessed on Sept. 2, 2009. National Vital Statistics Reports, Vol.58, No.1, August 19,2009. Available at http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_14.pdf. Accessed on Sept. 2, 2009.
  5. NCHS. Vaccination coverage estimates from the National Health Interview Survey: United States, 2008.
  6. Seasonal Influenza Vaccine Use by Adults in the U.S. Rand Flu Vaccine Study. Available at http://www.rand.org/health/projects/flu-survey/. Last Accessed November 3 2010.
  7. Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report. October 15 2010.
  8. Molinari, et al; The annual impact of seasonal influenza in the US: measuring disease burden and costs. Volume 25, Issue 27 28 June 2007, pgs 5086-5096.
  9. Nichol KL, D'Heilly SJ, Greenberg ME, Ehlinger E. Burden of influenza-like illness and effectiveness of influenza vaccination among working adults aged 50-64 years. Clin Infect Dis. 2009;48(3):299-301.
  10. Cortese MM, Baughman AL, Brown K, Srivastava P. A "new age" in pertussis prevention new opportunities through adult vaccination. Am J Prev Med. 2007;32(3):177-185.
  11. 9th Baby in California Dies from Whooping Cough. CNN Web site. Available at http://www.cnn.com/2010/HEALTH/09/17/california.whooping.cough/index.html?hpt=T2. Accessed on October 20, 2010.
  12. AK Jha, et al "Performance Measures, Vaccinations, and Pneumonia Rates Among High-Risk Patients in Veterans Administration Healthcare" American Journal of Public Health. 2007: 97, 12: 2167-2172.