Influenza vaccination of recommended adult populations, U.S., 1989-2005

Vaccine. 2008 Mar 25;26(14):1786-93. doi: 10.1016/j.vaccine.2008.01.040. Epub 2008 Feb 14.


Objective: To assess influenza vaccination coverage among recommended adult populations in the United States.

Methods: Data from the 1989 to 2005 National Health Interview Surveys (NHISs), weighted to reflect the civilian, non-institutionalized U.S. population, were analyzed to determine self-reported levels of influenza vaccination among persons aged >or=65 years, persons with high-risk conditions, health care workers (HCW), pregnant women, and persons living in households with at least one identified person at high risk of complications from influenza infection. We stratified data by race/ethnicity to identify racial/ethnic disparities.

Results: Vaccination coverage levels among all recommended adult populations peaked in 2004, then declined in 2005 in association with the 2004-2005 vaccine shortage. Coverage for adults >or=65 years of age increased from 30.1% (95% confidence interval [CI]: 28.8-31.3) in 1989 to 70.0% (68.0-71.5) in 2004. In 2004, coverage was 40.7% (39.0-42.5) for all adults 50-64 years, 27.2% (24.6-29.9) for adults aged 18-49 years with high-risk conditions, 43.2% (39.9-46.6) for health care workers, 21.1% (19.1-23.4) for non-high-risk adults aged 18-64 years with a high-risk household member, and 14.4% (8.8-22.9) for pregnant women. Among each of the recommended adult sub-groups, vaccination coverage was higher for non-Hispanic whites compared to minority groups.

Conclusions: By 1997, influenza vaccination coverage had exceeded the national 2000 objective of 60% among persons aged >or=65 years, but by 2004 still remains well below the national 2010 target of 90%. Coverage levels for other groups targeted for influenza vaccination also are far short of the Healthy People 2000 and 2010 goals of 60% for persons aged 18-64 years with high-risk conditions, health care workers, and pregnant women. A concerted effort to increase provider adoption of standards for adult immunization, public awareness, and stable vaccine supplies are needed to improve influenza vaccination rates among recommended groups, and to reduce racial and ethnic disparities.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Ethnic Groups
  • Female
  • Health Care Surveys
  • Health Personnel / statistics & numerical data
  • Healthcare Disparities / statistics & numerical data
  • Humans
  • Influenza, Human / immunology*
  • Influenza, Human / prevention & control*
  • Male
  • Mass Vaccination / statistics & numerical data*
  • Mass Vaccination / trends
  • Middle Aged
  • Pregnancy
  • Risk
  • Surveys and Questionnaires
  • United States