Infection spreads, yet adults lax in recommended vaccines

NATIONAL REPORTS-National attention has been focused on childhood immunizations in light of a California pertussis epidemic, but adults who could unwittingly transmit infectious diseases remain largely unvaccinated.

According to data released in November by the Centers for Disease Control and Prevention (CDC), vaccination levels for influenza, pneumococcal disease, and hepatitis B were below target levels in 2009, and vaccination levels for tetanus, diphtheria and pertussis (Tdap) were low, especially among healthcare personnel, who are at increased risk for acquiring-and transmitting-pertussis.

The highly contagious bacterial infection is also known as "whooping cough," and can last for six weeks or more. It can be fatal, especially for infants.

Additionally, just 11% of white adults, 4% of black adults, and 5% of Hispanic adults have received the herpes zoster (shingles) vaccine.

Older adults are more likely to be properly vaccinated, perhaps because they tend to have more routine visits with a healthcare provider, the CDC theorizes. Some 65% of white adults, 45% of black adults, and 40% of Hispanic adults, age 65 and older, have received the pneumococcal vaccine, and those numbers are slightly higher for the influenza vaccine. According to the federal Healthy People 2020 initiative, which the CDC cites, 90% of non-institutionalized adults ages 65 and older should get the pneumococcal and influenza vaccines.

Reasons for the low vaccination rates include patient indifference; poor doctor/patient communication; ignorance of newer vaccinations targeting adults; and adults' failure to appreciate the public health benefit vaccinations, experts say. But not surprisingly, the biggest reason is out-of-pocket costs for patients.

"In both the public and private side, there are frequently gaps in individuals' coverage for vaccines," says William Schaffner, MD, president of the National Foundation for Infectious Diseases, and chair, department of preventive medicine at the Vanderbilt University Medical School, Nashville. "This turns out to be the . . . most important barrier to providing immunizations adequately to our entire adult population."