CDC sees little growth in adult vaccine coverage

Jan 29, 2013 (CIDRAP News) – Coverage rates for vaccines recommended for adults remain stubbornly low, except for modest gains in two, the diphtheria with acellular pertussis vaccine (Tdap) and the human papillomavirus (HPV) vaccine in women, according to new federal estimates today.

The review, from the US Centers for Disease Control and Prevention (CDC), covers six vaccines routinely targeted to certain adult groups and excludes the influenza vaccine, which it reported on earlier. The agency's latest adult vaccination report compares 2011 coverage levels with those seen during 2010. The findings appear in an early online edition of Morbidity and Mortality Weekly Report (MMWR).

Howard Koh, MD, MPH, assistant secretary for health at the Department of Health and Human Services (HHS), said during a media telebriefing today that many adults have heeded recommendations this season to be immunized against flu, but he said health officials want to make sure adults are aware of other vaccines they should be getting, as well.

The adult immunization report covers Tdap, pneumococcal, hepatitis A, hepatitis B, HPV, and herpes zoster. "Far too few adults are vaccinated against these important diseases," he said, adding that decreasing the burden of the diseases is critical to the health of the country.

He also said the CDC's analysis detected racial disparities in adult vaccinations, with whites having higher levels than other groups.

Koh said healthcare reform measures offer support for adult vaccination by ensuring that there is no cost sharing for patients who get them through new group or private insurance plans. "We encourage all adults to talk to their doctors about what vaccines are appropriate for them," he said.

In another effort to raise adult vaccination rates, Koh announced the release of a new tool called Adult Vaccine Finder, powered by HealthMap, a data source based at Boston Children's Hospital. Koh said the tool is similar to the flu vaccine locator and can be found on the Web site.

Carolyn Bridges, MD, associate director for adult immunization with the CDC's National Center for Immunization and Respiratory Diseases, said the results in today's report are based on a 2011 National Health Interview Survey, a cross-sectional randomized in-person survey conducted by US Census Bureau workers.

Overall, Tdap coverage increased 4.3% from 2010 to 2011, pushing the coverage total to 12.5%, according to the report. Bridges pointed out that the coverage level for adults living with infants, who are too young to be vaccinated against pertussis, rose by 11% to 22%. The CDC has said that preliminary data suggest that in 2012 the United States had the highest number of pertussis cases in a single year since 1955.

Coverage for one or more dose of HPV vaccine in young women grew from 20.7% in 2010 to 29.5% in 2011, according to the CDC. However, the level in Hispanic women lagged.

For the other vaccines, which showed little growth, coverage level increases were: 1.6% for the pneumococcal vaccine, 1.8% for hepatitis A, 2.1% for hepatitis B, and 1.4% for herpes zoster.

"While we're please to see increases, these numbers remain low overall, and racial disparities remain," Bridges said.

Targets for three of the vaccines—pneumococcal, herpes zoster, and hepatitis B for healthcare workers—are included in the Healthy People 2020 report, and the coverage levels that the CDC is seeing for all of them are well below the goals, she said.

The lack of progress in herpes zoster vaccine coverage could relate to problems with supply of the vaccine, and health officials may see that number rise now that there are fewer difficulties with availability, Bridges said.

CDC. Noninfluenza vaccination coverage among adults—United States, 2011. MMWR 2013 Jan 29 [Full text]

See also:

Adult Vaccine Finder

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