Meeting the Challenges of Immunizing Adults

Bridges, Carolyn B.; Hurley, Laura P.; Williams, Walter W.; Ramakrishnan, Aparna; Dean, Anna; Groom, Amy V.

doi:10.1016/j.amepre.2015.08.014

Cited by 54 publications

(43 citation statements)

References 41 publications

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“…Racial/ethnic differences in coverage persisted for all seven vaccines in this report with higher coverage, generally, for whites compared with most other groups. Factors that contribute to low adult vaccination rates (including patient- and provider-level barriers and systems-related factors) have been described ( 5 , 88 – 96 ) and effective, evidence-based strategies to improve vaccine use have been reported ( 13 , 88 ). The National Vaccine Advisory Committee published updated standards for adult immunization practice in 2014 with the intent of improving adult vaccination coverage of ACIP-recommended vaccines.…”

Section: Discussionmentioning

confidence: 99%

Surveillance of Vaccination Coverage among Adult Populations — United States, 2015

Williams

O’Halloran

et al. 2017

MMWR Surveill. Summ.

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395

332

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Problem/ConditionOverall, the prevalence of illness attributable to vaccine-preventable diseases is greater among adults than among children. Adults are recommended to receive vaccinations based on their age, underlying medical conditions, lifestyle, prior vaccinations, and other considerations. Updated vaccination recommendations from CDC are published annually in the U.S. Adult Immunization Schedule. Despite longstanding recommendations for use of many vaccines, vaccination coverage among U.S. adults is low.Period CoveredAugust 2014–June 2015 (for influenza vaccination) and January–December 2015 (for pneumococcal, tetanus and diphtheria [Td] and tetanus and diphtheria with acellular pertussis [Tdap], hepatitis A, hepatitis B, herpes zoster, and human papillomavirus [HPV] vaccination).Description of SystemThe National Health Interview Survey (NHIS) is a continuous, cross-sectional national household survey of the noninstitutionalized U.S. civilian population. In-person interviews are conducted throughout the year in a probability sample of households, and NHIS data are compiled and released annually. The survey objective is to monitor the health of the U.S. population and provide estimates of health indicators, health care use and access, and health-related behaviors.ResultsCompared with data from the 2014 NHIS, increases in vaccination coverage occurred for influenza vaccine among adults aged ≥19 years (a 1.6 percentage point increase compared with the 2013–14 season to 44.8%), pneumococcal vaccine among adults aged 19–64 years at increased risk for pneumococcal disease (a 2.8 percentage point increase to 23.0%), Tdap vaccine among adults aged ≥19 years and adults aged 19–64 years (a 3.1 percentage point and 3.3 percentage point increase to 23.1% and to 24.7%, respectively), herpes zoster vaccine among adults aged ≥60 years and adults aged ≥65 years (a 2.7 percentage point and 3.2 percentage point increase to 30.6% and to 34.2%, respectively), and hepatitis B vaccine among health care personnel (HCP) aged ≥19 years (a 4.1 percentage point increase to 64.7%). Herpes zoster vaccination coverage in 2015 met the Healthy People 2020 target of 30%. Aside from these modest improvements, vaccination coverage among adults in 2015 was similar to estimates from 2014. Racial/ethnic differences in coverage persisted for all seven vaccines, with higher coverage generally for whites compared with most other groups. Adults without health insurance reported receipt of influenza vaccine (all age groups), pneumococcal vaccine (adults aged 19–64 years at increased risk), Td vaccine (adults aged ≥19 years, 19–64 years, and 50–64 years), Tdap vaccine (adults aged ≥19 years and 19–64 years), hepatitis A vaccine (adults aged ≥19 years overall and among travelers), hepatitis B vaccine (adults aged ≥19 years, 19–49 years, and among travelers), herpes zoster vaccine (adults aged ≥60 years), and HPV vaccine (males and females aged 19–26 years) less often than those with health insurance. Adults who reported having a usual place for health...

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Section: Discussionmentioning

confidence: 99%

Surveillance of Vaccination Coverage among Adult Populations — United States, 2015

Williams

O’Halloran

et al. 2017

MMWR Surveill. Summ.

Self Cite

395

332

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“…12 Influenza vaccine coverage was 45% in adult cancer patients in US, with increasing rates among elderly and those with higher income. 13 A previous study in cancer patients from Turkey showed overall vaccination rate as 17% and 4.2% for influenza and pneumococci, respectively. 7 Main reason for denial of vaccination in our study was the lack of acknowledgement by the treating physician as reported by patients.…”

Section: Discussionmentioning

confidence: 99%

Vaccination Attitudes Among Patients with Cancer Receiving Chemotherapy.

Akın¹,

Dizdar²,

Özışık³

et al. 2016

UHOD

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Immunization against vaccine preventable diseases is an essential but mostly overlooked issue in oncology practice. We aimed to investigate the utilization of adult immunization recommendations and the perception of the patients with cancer receiving chemotherapy on immunization. A 15-item questionnaire about immunization in adults with cancer diagnosis was administered to patients with various cancers treated in daycare chemotherapy unit of Hacettepe University Cancer Institute. Total of 229 patients completed the survey. Fifty-four percent of patients were vaccinated at least once, most commonly against influenza and tetanus over 18 years old. Higher rate of participants was opposed to vaccination of patients with cancer diagnosis compared with those who were opposed to vaccination of healthy adults. Vaccination was never recommended in 93% of the participants. Only 9% of patients (n=21) were shot after cancer diagnosis. There was a strong association between doctor's advice and vaccination status. Twelve of 15 patients (80%) who were recommended to be vaccinated did so whereas only 9 of 214 remaining patients (4.2%) were vaccinated. Among those not vaccinated after diagnosis of cancer, most frequent reason was; not recommended by the doctor. Neither vaccination rates nor perceptions on adult immunization differed by age, gender, marital status, presence of co-morbidity or type of cancer. Among adult patients with cancer and receiving chemotherapy, immunization rates were found to be very low. Main reason was the lack of recommendation by the primary physician involved in the treatment, mostly oncologist. Awareness on this issue in physicians, particularly oncologists, may increase vaccination rates. Keywords: Adult immunization, Vaccine preventable disease, Cancer chemotherapy ÖZET Kemoterapi Alan Kanser Hastalarının Aşı DavranışlarıÖnlenebilir hastalıklara karşı aşılanma onkoloji pratiğinde ihmal edilen bir konudur. Bu çalışmada kemoterapi alan kanser hastalarının erişkin aşılanması ile ilgili görüş ve algılarını, düşük aşılanma oranlarının nedenlerini araştırmayı amaçladık. Hacettepe Üniversitesi Onkoloji Hastanesi ayaktan tedavi ünitesinde çeşitli kanser tanıları ile kemoterapi almakta olan erişkin hastalara, erişkin aşılanması ile ilgili 15 sorudan oluşan bir anket uygulandı. Toplam 229 hasta anketi tamamladı. Hastaların %74,7'si erişkinlerin de aşılanması gerektiğini düşünmekteydi. En sık influenza ve tetanos aşısı olmak üzere hastaların %54'ü 18 yaşından sonra en az bir defa aşılanmıştı. Katılımcıların %16,6'sı erişkinlerin aşılamasına karşıydı, daha yüksek oranda bir bölümü ise kanserli hastaların aşılanmasına karşı olduklarını belirtti. Hastaların %93'üne kanser tanısı aldıktan sonra hiç aşı önerilmemişti. Sadece 21 hastanın (%9) tanı sonrası aşı yaptırdığı anlaşılırken en sık influenzaya karşı aşılanma görüldü. Doktor önerisi ve aşılanma durumu arasında anlamlı bir ilişki tespit edildi. Kendisine onkoloğu tarafından aşı önerilen 15 hastanın 12'si(%80) aşılanırken, önerilmeyen 214 hastadan sad...

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“…An accelerated schedule administered on days 0, 7, and 21–30 days (booster at 12 months) may be used for rapid protection [25,29]. Additional factors that may contribute to low vaccination coverage among adult travelers include: limited awareness among the public about adult vaccination, failure of providers to routinely assess vaccine needs of adult patients, the financial risks providers incur to stock vaccines and provide vaccination services to adults, acute medical care taking precedence over providing vaccination services, the inability to assess adult patients’ vaccination status, some providers not perceiving responsibility as the vaccinator, and organizational challenges of vaccine administration [30–38]. …”

Section: Discussionmentioning

confidence: 99%

Hepatitis B vaccination coverage among adults aged ≥ 18 years traveling to a country of high or intermediate endemicity, United States, 2015

Williams

Nelson

2018

Vaccine

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Background: Persons from the United States who travel to developing countries are at substantial risk for hepatitis B virus (HBV) infection. Hepatitis B vaccine has been recommended for adults at increased risk for infection, including travelers to high or intermediate hepatitis B endemic countries. Purpose: To assess hepatitis B vaccination coverage among adults ≥ 18 years traveling to a country of high or intermediate endemicity from the United States. Methods: Data from the 2015 National Health Interview Survey (NHIS) were analyzed to determine hepatitis B vaccination coverage (≥ 1 dose) and series completion (≥ 3 doses) among persons aged ≥ 18 years who reported traveling to a country of high or intermediate hepatitis B endemicity. Multivariable logistic regression and predictive marginal analyses were conducted to identify factors independently associated with hepatitis B vaccination. Results: In 2015, hepatitis B vaccination coverage (≥ 1 dose) among adults aged ≥ 18 years who reported traveling to high or intermediate hepatitis B endemic countries was 38.6%, significantly higher compared with 25.9% among non-travelers. Series completion (≥ 3 doses) was 31.7% and 21.2%, respectively (P < 0.05). On multivariable analysis among all respondents, travel status was significantly associated with hepatitis B vaccination coverage and series completion. Other characteristics independently associated with vaccination (≥ 1 dose, and ≥ 3 doses) among travelers included age, race/ethnicity, educational level, duration of U.S. residence, number of physician contacts in the past year, status of ever being tested for HIV, and healthcare personnel status. Conclusions: Although travel to a country of high or intermediate hepatitis B endemicity was associated with higher likelihood of hepatitis B vaccination, hepatitis B vaccination coverage was low among adult travelers to these areas. Healthcare providers should ask their patients about travel plans and recommend and offer travel related vaccinations to their patients or refer them to alternate sites for vaccination.

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Meeting the Challenges of Immunizing Adults

Cited by 54 publications

References 41 publications

Surveillance of Vaccination Coverage among Adult Populations — United States, 2015

Surveillance of Vaccination Coverage among Adult Populations — United States, 2015

Vaccination Attitudes Among Patients with Cancer Receiving Chemotherapy.

Hepatitis B vaccination coverage among adults aged ≥ 18 years traveling to a country of high or intermediate endemicity, United States, 2015

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Meeting the Challenges of Immunizing Adults

Cited by 54 publications

References 41 publications

Surveillance of Vaccination Coverage among Adult Populations — United States, 2015

Surveillance of Vaccination Coverage among Adult Populations — United States, 2015

Vaccination Attitudes Among Patients with Cancer Receiving Chemotherapy.

Hepatitis B vaccination coverage among adults aged ≥ 18 years traveling to a country of high or intermediate endemicity, United States, 2015

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Product

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Hepatitis B vaccination coverage among adults aged ≥ 18 years traveling to a country of high or intermediate endemicity, United States, 2015