October 22-28, 1989, is the fourth annual National Adult
Immunization
Awareness Week. This observance emphasizes the importance of
appropriately immunizing all adults against eight diseases:
diphtheria,
hepatitis B, influenza, measles, mumps, pneumococcal disease,
rubella,
and tetanus. Immunization programs have markedly reduced the
incidence
of vaccine-preventable diseases in children, but many adults remain
susceptible because they are inadequately immunized (Tables 1 and
2).
National Adult Immunization Awareness Week highlights
collaborative
efforts by federal, state, and local health agencies, public health
organizations, and professional, private, volunteer, and other
organizations to improve adult immunization. These efforts have
included the following:
In June 1988, greater than 40 health organizations formed the
National Coalition for Adult Immunization (NCAI). NCAI's major
goals
include increasing public- and private-sector collaboration and
involvement in improving the immunization status of adults through
information and education programs for providers and consumers.
In October 1988, the Health Care Financing Administration (HCFA)
collaborated with CDC in providing resources for nine demonstration
projects. Conducted by state, county, and city health departments
and
one university medical center, these projects will determine
whether
Medicare payment for influenza immunization increases vaccine
coverage
and reduces morbidity, mortality, and demand for health-care
services.
The projects were initiated in 1988, and all will be completed by
1992.
In 1988, the State of Hawaii Department of Health, assisted by
HCFA
and CDC, implemented a Pneumococcal Disease Initiative. The
initiative
included evaluation of the incidence of pneumococcal bacteremia and
mortality in Hawaii; surveys of immunization knowledge, attitudes,
and
practices among Hawaii physicians and older residents; and a
statewide
vaccination program for Medicare beneficiaries. From September 1,
1988,
through February 23, 1989, community-based mobile clinics
administered
pneumococcal vaccine to 15,909 elderly residents. Concurrent with
the
initiative, vaccine sales in the private sector indicated that
vaccine
use more than doubled.
In 1987, CDC entered into a 3-year cooperative agreement with
the
American Managed Care and Review Association to assist health
maintenance organizations (HMOs) in developing adult immunization
policies and practices. The agreement involves activities to
determine
HMO policies and procedures, immunization coverage, and disease
impact
and to develop intervention strategies. Six HMOs, representing
greater
than 50,000 enrollees, are participating.
Reported by: Div of Immunization, Center for Prevention Svcs, CDC.
Editorial Note
Editorial Note: Each year, adults develop vaccine-preventable
diseases
because they have not received the recommended vaccines (1-7). For
example, in each of several recent epidemics, greater than 40,000
influenza-related excess deaths occurred (3,8). Approximately
40,000
deaths related to pneumococcal infections and an estimated 300,000
new
hepatitis B cases occur annually. Among young adults, the incidence
of
measles and mumps has increased (4,9). Ten percent to 15% of
childbearing-aged women are not immune to rubella, and most
Americans
greater than 60 years of age lack adequate protection against
tetanus
and diphtheria. Safe and effective vaccines are available for all
these
diseases, and the cost of vaccination is substantially less than
the
cost of treating the disease.
Improving vaccine use among adults requires a multifaceted
strategy
involving collaboration of health-care providers, consumer groups,
and
public and private organizations. National Adult Immunization
Awareness
Week draws attention to efforts that promote prevention and control
of
vaccine-preventable diseases.
References
ACIP. Recommendations for protection against viral hepatitis.
MMWR
1985;34:313-24,329-35.
ACIP. Update on hepatitis B prevention. MMWR 1987;36:353-60,366.
ACIP. Prevention and control of influenza: part I, vaccines.
MMWR
1989;38:297-8,303-11.
Lui KJ, Kendal AP. Impact of influenza epidemics on mortality in
the
United States from October 1972 to May 1985. Am J Public Health
1987;77:712-6.
9. ACIP. Mumps prevention. MMWR 1989;38:388-92,397-400.
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