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30 J.L. Med. & Ethics 128 (2002)
Immunization for Seniors

handle is hein.journals/medeth30 and id is 486 raw text is: Immunization for Seniors

Dale W Bratzler, B. F Chris Christiaens, Katherine Hempstead, Kristin L. Nichol
Vaccine-preventable diseases remain a significant health problem for adults in the United
States. Far more adults die from the complications of vaccine-preventable diseases than
do children in this country. Available vaccines that are effective in preventing morbidity
and mortality from these conditions are underutilized, and significant racial and ethnic
disparities in rates of utilization of adult vaccines persist. A variety of important vaccine-
preventable diseases affect seniors. However, influenza and pneumococcal infections
stand out as being responsible for more cases and more deaths each year among seniors
than all other vaccine-preventable diseases in the United States combined. Current
vaccination rates for these two diseases are far short of the Healthy People 2010 target
rates of 90% immunization of the population of adults aged 65 years or over. Despite
state efforts to improve vaccination rates of seniors, efforts that have included regulatory
and educational approaches, significant challenges remain in designing immunization
programs for seniors that are universally effective.

E ach year in the United States, 50,000-
90, 1000 adults die of vaccine preventable
diseases. The number of adults who die of
vaccine preventable disease far exceeds the
number of children who die from these condi-
tions.1,2 Despite the fact that cost-effective adult
vaccines prevent morbidity and mortality from
these conditions, these vaccines are underuti-
lized. The General Accounting Office (GAO)
recently reported to Congress that while the use
of preventive services (including adult vaccines)
offered under the Medicare Program has
increased over time, use of these services varies.
In addition to considerable differences in use
between states, there is also marked variation in
use of these services by racial and ethnic group,
income, and educational level.3 As noted by the
GAO, the differences in utilization of preventive
services among racial and ethnic groups were
greatest for immunizations.
The majority of adult deaths from vaccine-
preventable diseases is due to influenza and

pneumococcal disease. Data collected by the
Centers for Disease Control and Prevention
(CDC) in the National Health Interview Survey4
and the National Nursing Home Survey
demonstrate the underutilization of vaccines for
these two diseases.
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N 50-64 years   W65 years and over



1997              1998             1999              2000
Source: Centers for Disease Control and Prevention. Early release of selected
estimates from the National Health Interview Survey (NHIS). Data from January - June
2001. hftp://www.cdc.gov/nchs/nhis.htm (accessed 6/27/02).

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