WASHINGTON — States require that children have all their immunizations before they can enroll in school. Veterinarians send reminder cards to pet owners when Fido or Tabby is due for a shot. No such safety net exists for adults, however, and especially for the elderly, who are particularly susceptible to many diseases that vaccines can prevent, according to a new report about the low rate of adult immunization.
It found that a third of seniors had received no immunizations against pneumonia in 36 states as of 2008. Just less than a third of people who were older than 65 also went without the seasonal flu vaccine that year.
"The country has an absolutely stunningly first-rate system for immunizing children, but too many adults fall through the cracks," said Dr. William Schaffner, an expert on infectious diseases at the Vanderbilt University School of Medicine.
The report was prepared by the Trust for America's Health, a nonpartisan health research group; the Infectious Diseases Society of America; and the Robert Wood Johnson Foundation, the largest health care philanthropy in the country.
The report, "Adult Immunization: Shots to Save Lives," says that millions of Americans forgo routine vaccinations for preventable diseases. Some 40,000 to 50,000 adults die every year as a result.
Failure to use the vaccines adds about $10 billion annually to the cost of heath care, according to the U.S. Centers for Disease Control and Prevention.
Seasonal flu can lead to pneumonia among the elderly, and it can be particularly lethal in that age group, experts said.
Oregon had the highest immunization rate for pneumonia among seniors. Just more than one in four didn't get the vaccine. Washington, D.C., had the lowest rate; almost half the elderly population hadn't gotten it.
One reason for the low immunization rates among adults, according to the report, was that unlike schoolchildren or the military, many adults aren't connected to some kind of institution or network that requires vaccinations.
The report also says that adults usually see medical specialists for particular problems and, unlike children, don't have primary care physicians, who oversee their patients' overall health.
Other roadblocks were the high costs of some vaccines, misinformation about their effectiveness and safety, and insurance coverage that limits or doesn't offer vaccine coverage.
Concern about the widespread availability of vaccines has figured in the debate over health care. Both the House of Representatives and Senate bills contain language that would make vaccines more easily obtainable.
"We need a national strategy to make vaccines a regular part of medical care and educate Americans about the effectiveness and safety of vaccines," said Jeffrey Levi, the executive director of the Trust for America's Health.
The CDC has recommended that everyone older than 65 be vaccinated for pneumonia. It hopes to reach a 90 percent immunization rate this year.
The report cites a 2007 National Immunization Survey by the CDC to highlight the problem of low adult vaccination rates:
- Just 2.1 percent of eligible adults had received vaccines for tetanus, whooping cough and diphtheria.
"It sort of plateaued at that level," Glen Nowack, a spokesman for the CDC, said of the seasonal flu shots. "The next groups are not as easily persuadable. They have not been in the habit of getting the influenza vaccine. They have concerns about it, or don't believe it's going to be as effective. We've been working real hard to try and persuade them."
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