Many Adults Still Missing Vaccinations

Non-influenza vaccine coverage for adults increased somewhat in 2012, but continued to lag behind goals, particularly for racial and ethnic minorities.

Modest improvements in coverage were observed for some vaccines, but coverage rates among adults continued to fall short of targets in 2012, according to a report published in the February 7, 2014, issue of the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report. The report also noted lagging coverage rates among minority patients.

Researchers from the CDC analyzed data from the 2012 National Health Interview Survey to evaluate coverage for pneumococcal, tetanus, hepatitis A, hepatitis B, herpes zoster, and human papillomavirus (HPV) vaccines among adults aged 19 and older. The data was then analyzed by age, vaccination target criteria, and race and ethnicity.

Compared with 2011, coverage increased slightly for the herpes zoster, HPV, and Tdap vaccinations. Herpes zoster vaccination rates increased from 15.8% to 20.1% among those aged 60 and older, and coverage with at least 1 dose of the HPV vaccine among young women aged 19 to 26 increased from 29.5% to 34.5%. Rates of vaccination with at least 1 dose of the HPV vaccine also increased 6.7 percentage points to 28.2% among women aged 22 to 26, while rates for men aged 19 to 21 remained very low at 2.4%. Tdap coverage increased 3.2 percentage points to 15.6% among adults aged 19 to 64. However, Tdap vaccination rates among adults who reported living with an infant remained similar to those in 2011.

Despite these improvements, coverage rates for the other vaccines included in the report failed to improve. Coverage rates for the herpes zoster, hepatitis B, and pneumococcal vaccines remained below their respective Healthy People 2020 goals. In addition, racial and ethnic gaps in coverage persisted and actually widened for the Tdap, herpes zoster, and HPV vaccinations. Tdap coverage was just 9.8% among black patients and 8.7% among Hispanic patients, compared with 16.1% among white patients. Herpes zoster vaccination rates among white patients aged 60 and older increased to 22.8%, while fewer than 9% of black and Hispanic patients in this age group were vaccinated. And only 29.1% of black, 18.7% of Hispanic, and 15.6% of Asian women aged 19 to 26 had received at least 1 dose of the HPV vaccine, compared with 42.2% of white patients.

An editorial note included in the report suggests that improvements in adult vaccination rates are needed in order to prevent the spread of vaccine-preventable diseases, especially pertussis among infants. “The Community Preventive Services Task Force and other authorities have recommended that health-care providers incorporate vaccination needs assessment, recommendation, and offer of vaccination into routine clinical practice for adult patients,” the report concludes.