In 1999, 64,400 cases of invasive pneumococcal disease and 5,900 deaths were estimated to occur in the U.S., with the highest case fatality among the elderly and persons with underlying medical conditions. The Advisory Committee on Immunization Practices recommends pneumococcal vaccination for all persons aged ³65 years and persons aged 2-64 with medical conditions placing them at increased risk for invasive pneumococcal disease. Data from the 1997 National Health Interview Survey, weighted to reflect the U.S. non-institutionalized population, were analyzed to determine self-reported vaccination coverage levels among high-risk adults aged 18-64 years in 1997. We used multivariate analysis to identify factors associated with pneumococcal vaccination including demographics, access to care, specific medical conditions, and severity of illness. Pneumococcal vaccination coverage for adults aged 18-64 years with high-risk medical conditions such as diabetes, cancer, chronic heart, lung, kidney and liver disease was only 12.9% (95% confidence interval [CI]: 11.8-14.0) in 1997, compared to 42.4% (40.9-43.9) among adults aged ³65 years. Factors independently associated (Odds ratio, 95% CI) with pneumococcal vaccination among high-risk adults aged 18-64 years included: age ³50 (1.6, 1.3-2.0), influenza vaccination in last year (5.7, 4.6-7.2), diabetes (1.6, 1.3-2.0), chronic lung disease (1.6, 1.3-2.1), unemployment (1.4, 1.1-1.8), saw medical specialist in past 12 months (1.4, 1.1-1.7) and received homecare in past 12 months (1.9, 1.2-2.8). Medical conditions and severity of disease appeared to be associated with vaccination. Pneumococcal vaccination levels among high-risk adults aged <65 years were far below the Healthy People 2000/2010 objectives of 60%.
Learning Objectives:
Keywords: Adult Health, Immunizations
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.