Vaccination rates among the general adult population and high-risk groups in the United States

Abstract

Background: In order to adequately assess the effectiveness of vaccination in helping to control vaccine-preventable infectious disease, it is important to identify the adherence and uptake of risk-based recommendations.

Methods: The current project includes data from five consecutive datasets of the National Health and Wellness Survey (NHWS): 2007 through 2011. The NHWS is an annual, Internet-based health questionnaire, administered to a nationwide sample of adults (aged 18 or older) which included items on vaccination history as well as high-risk group status. Vaccination rates and characteristics of vaccinees were reported descriptively. Logistic regressions were conducted to predict vaccination behavior from sociodemographics and risk-related variables.

Results: The influenza vaccination rate for all adults 18 years and older has increased significantly from 28.0% to 36.2% from 2007 to 2011 (ps<.05). Compared with those not at high risk (25.1%), all high-risk groups were vaccinated at a higher rate, from 36.8% (pregnant women) to 69.7% (those with renal/kidney disease); however, considerable variability among high-risk groups was observed. Vaccination rates among high-risk groups for other vaccines varied considerably though all were below 50%, with the exception of immunocompromised respondents (57.5% for the hepatitis B vaccine and 52.5% for the pneumococcal vaccine) and the elderly (50.4% for the pneumococcal). Multiple risk factors were associated with increased rate of vaccination for most vaccines. Significant racial/ethnic differences with influenza, hepatitis, and herpes zoster vaccination rates were also observed (ps<.05).

Conclusions: Rates of influenza vaccination have increased over time. Rates varied by high-risk status, demographics, and vaccine. There was a pattern of modest vaccination rate increases for individuals with multiple risk factors. However, there were relatively low rates of vaccination for most risk-based recommendations and all fell below national goals.

Figure 1. Percentage of high-risk groups who have been vaccinated.

N/A: risk category is not applicable to this particular vaccine according to the ACIP; immunocompromised: (HIV/AIDS); CHD: Congestive heart failure, heart attack, angina, arrhythmia; lung conditions: COPD/emphysema/bronchitis, asthma; liver disease: Hepatitis B, Hepatitis C, chronic liver disease, cirrhosis; renal/kidney disease: chronic kidney disease, moderate-severe renal disease; MSM: men who have sex with men; Any high risk group: membership in any of the high-risk categories above.

Figure 2. Vaccination rates by number of risk factors.