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The Unprotected: Characteristics of Older Adults Who Did Not Receive Their Annual Influenza Immunization Patricia Porter, UCSF Nisha Gandhi, MPH , CA DHS Howard Backer, MD, MPH , CA DHS Julie Heinzerling, MPH , Immunize LA Kids
ABSTRACT: The Centers for Disease Control and Prevention
(CDC) estimate that influenza causes 36,000
deaths in the United States every year, and
results in direct medical care costs of over $4.6
billion annually. Influenza and pneumonia are
responsible for 8,800 deaths per year in
California alone, making it the sixth leading
cause of death among adults in the state, yet the
illnesses are largely preventable by immunization.
The California Adult Immunization Coalition
(CAIC) is comprised of more than 20 organizations
across California who are working together
to increase immunization rates for influenza
and pneumonia in adults. The CAIC analyzed
influenza vaccination rates in California using
data from the 2001 California Health
Interview Survey (CHIS), and compared the
results to the national Healthy People 2010 goals
for adult immunization. The national goals
specify that 90% of older adults (age 65 and
over) should be immunized against influenza
annually by the year 2010 (i.e., less than 10%
should remain unimmunized).
To deepen our understanding of this important
public health issue, the CAIC has added several
specific questions concerning adult immunizations
to the 2003 CHIS survey. Results of this most
recent survey will be available next year.
Increasing California’s adult immunization rates
to reach the national goal requires the persistent
efforts of multiple sectors including vaccine suppliers,
health departments, and individual health
clinics and health providers’ offices.
Key findings are:
• 32.6% of older adults (age 65 and over) in
California for whom annual flu shots are recommended
did not get immunized in 2001.
• Immunization rates among older adults varied by
region; rates were found to be lowest in the Los
Angeles region (63.9%) and highest in the
Sacramento region (77.0%). However, no regions
in California came close to meeting the national
goal that 90% of older adults be immunized
against influenza.
• Although there was a strong age-related trend for
the elderly to get an influenza immunization, 27%
remained unimmunized even among people aged
75 years and over.
• Among the state’s racial and ethnic groups, Latinos
(46%) and African Americans (47%) over the age of
65 were almost twice as likely to go unimmunized
when compared with Asians (27%) and Whites
(28%) in the same age group.
• Persons with a "medical home" (a regular place to
get medical care) were more than twice as likely to
get immunized compared to those who did not
have a usual source of care.
• The more often an individual saw the doctor, the
more likely he or she was to get a flu shot, however,
large numbers of people with regular access to
care were still unimmunized.
• Patients covered by Medicare were immunized
more often than those who were not covered; in
the Medicare-covered group 32.7% were not
immunized.
• There were no differences found in immunization
rates between women and men.
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