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Adult and Adolescent Immunization
WHAT IS THE PUBLIC HEALTH ISSUE?
Each year, 46,000 to 48,000 adults die from vaccine-preventable
diseases. Influenza vaccination levels remain low for adults. As of 2002,
only 67% of adults aged 65 years or older and 29% of high-risk adults aged
18 to 64 years reported receiving influenza vaccination. Influenza
vaccination coverage levels among persons aged 65 years or older were lower
among African Americans (48%) and Hispanics (54%) compared to non-Hispanic
whites (68%). The gap is even wider for pneumococcal vaccination. In 2000,
hepatitis B coverage, recommended for all adolescents, was only 44% among 13
to 15 years old, based on parent-held vaccination records.
WHAT HAS CDC ACCOMPLISHED?
In 2001, the Department of Health and Human Services made eliminating
racial and ethnic disparities in influenza and pneumococcal vaccination for
people 65 years of age and older a priority. To address this priority, CDC
established the Racial and Ethnic Adult Disparities in Immunization
Initiative (READII) demonstration project in 5 sites (Chicago, Rochester
[NY], San Antonio, Milwaukee, and 19 counties in the Mississippi Delta
region). These sites are developing and implementing community-based plans
by partnering with public health professionals, healthcare providers, and
community organizations. CDC and the Centers for Medicare and Medicaid
Services (CMS) also continue to collaborate to improve influenza and
pneumococcal vaccination rates in nursing homes and hospitals.
CDC also makes available a number of tools for immunization programs:
- Published by CDC in 2002, the Adult Immunization Schedule is the first
schedule ever approved by the Advisory Committee on Immunization
Practices; it has also been accepted by the American College of
Obstetricians and Gynecologists and the American Academy of Family
Physicians.
- In 2003, the Standards for Adult Immunization Practices
(Standards) were revised based on previous efforts to improve adult
immunization coverage and in response to changes in the healthcare
delivery system. These revised standards focus on vaccine accessibility,
effective communication of vaccination information, improving vaccination
rates, and community partnership development.
- The Adult Clinic Assessment Software Application, created in 2002, is
a tool that practitioners or clinic managers can use to estimate the
vaccine coverage levels of the patients they serve and to help determine
an appropriate course of action to improve coverage.
- A collaboration between CDC and the Association of Teachers of
Preventive Medicine produced a "What Works" CD-ROM which individual
practice and clinic staff can use to test their adult vaccination
knowledge; reference a substantial amount of background material; review
frequently asked questions and model practices; select strategies to
increase vaccination rates; and create an action plan.
WHAT ARE THE NEXT STEPS?
- Continue working with other federal agencies; state and local health
departments; and private and community partners to
- Support state health departments to develop comprehensive plans for
vaccination of adolescents and adults.
- Address and eliminate persistent racial and ethnic disparities in
adult immunization coverage levels.
- Develop, evaluate, and promote standing orders and patient/provider
reminder systems.
- Help improve physician and institutional practices that lead to
increased vaccination coverage among adolescents and adults.
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last reviewed January 2004
Centers for Disease Control and Prevention
Programs In Brief
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