Adult vaccination coverage, compliance varies widely by state
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Adult vaccination coverage and compliance varies substantially by state, even with adjustments for individual state-characteristics, according to study results presented at IDWeek.
The study examined vaccination information for influenza, pneumococcus, Tdap and herpes zoster (HZ) and found that the “coverage rates for recommended vaccines were generally low,” Elizabeth M. La, PhD, associate director of health economics at RTI Health Solutions, explained.
“As compared with the childhood immunization program, clinicians treating adults are at a bit of a disadvantage because there aren’t scheduled ‘well-adult visits’ similar to well-child visits where vaccinations can be administered,” La told Healio. “Given the relatively low coverage rates from this study, each patient encounter should be viewed as an opportunity to make sure that adults are up to date with their recommended vaccines to help increase coverage against these vaccine-preventable diseases.”
La and colleagues analyzed state-level vaccination data from 2015 to 2017 via the Behavioral Risk Factor Surveillance System. They evaluated the effects of both individual and state-level aspects of adult vaccination coverage and updated previous estimated coverage rates for the four vaccines.
For 2017, vaccination rates varied between states for influenza (35.1%-48.1%), pneumococcus (68.2%-80.8%) and HZ (30.5%-50.9%), even after adjusting for individual characteristics. In 2016, rates varied for the Tdap vaccine (21.9%-46.5%).
La said the researchers were surprised to find that adults were more likely to receive Tdap and pneumococcal vaccines in states that permit “personal belief” exemptions for child vaccination.
“Additional research is needed to further understand our findings. For example, it’s possible that adults in states with personal belief exemption policies may be more aware of anti-vaccination groups within their state and increased disease incidence risks, making them more inclined to be vaccinated,” La said. “Or state and local health departments may be taking extra steps within these states to counteract the exemptions and increase coverage.”
According to La, although they identified state-level factors that may impact vaccination — “indicating that there may be steps that states can take to improve coverage” — the substantial variation across states “remained unexplained and warrants further investigation.”
“The state-level factors that we investigated were not inclusive of all factors that may be affecting vaccination coverage, so additional research could focus on a more comprehensive list of state and/or local factors potentially impacting coverage,” La said.
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Hunter S, et al. Abstract 87. Presented at: IDWeek; Oct. 21-25, 2020 (virtual meeting).
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