Pneumococcal and Influenza Vaccination Levels Among Mahoning County Older Adults

From 1972 through 1991, influenza caused an estimated 20,000 excess deaths during each of 10 epidemics. Pneumococcal infections cause an estimated 40,000 deaths annually in the U.S. and are the most common cause of bacterial pneumonia requiring hospitalization. Despite the threat that influenza and pneumonia poses to older adults, vaccination levels against these diseases remained low until 1993, when self-reported vaccination levels against these diseases began to increase in the U.S. This increase can be attributed to several factors, among them:

Thousands of older adults in Mahoning County receive their flu shots each year from their physicians, the health department, or a visiting nurse. In the last few years, drug stores and social service agencies serving older adults have begun to offer flu shots to their customers and clients. The Mahoning County Board of Health vaccinated over 3,000 older adults and others at risk for serious health consequences from influenza and pneumonia infection in 1996.

Despite these community efforts, the influenza vaccination level of 44.2 percent for persons ages 65 and older in Mahoning County was below the Ohio level of 50.1 percent in 1993, and well below the Healthy People 2000 objective of 60 percent for the Year 2000.

Self-reported coverage levels for pneumococcal vaccination were substantially lower than for influenza vaccination in Mahoning County (27.9%) in 1993. Coverage may be lower because many patients and providers are not aware of the need for pneumococcal vaccination for persons aged 65 and older. A single dose of pneumococcal vaccine protects an older person against bacterial pneumonia for many years and the vaccination is reimbursable by Medicare.

In contrast to U.S. levels, non-whites in Mahoning County were more likely to report influenza and pneumonia vaccination in 1993, as were persons with college education (see table below).

Characteristics of Older Adults with Higher Vaccination Levels in Mahoning County, 1993.

Race     Influenza (%)     Pneumonia (%)
White    
42.0(52.2)#
    
27.5 (29.8)
Non-White    
62.5(33.1)
    
31.3(25.0)
                   
Education                
College degree    
66.7
    
33.3
Less than high school    
34.5
    
34.5
* persons ages 65 and older                 
#U.S. estimates from 1993 in parentheses                

The Mahoning County and Youngstown Boards of Health will continue to offer influenza and pneumonia vaccinations at many locations in the County before each flu season. The Board of Health urges physicians, hospitals, and other health care providers to routinely offer these vaccines to their older patients. By expanding the availability of the vaccine and awareness of its value, Mahoning County can achieve Healthy People 2000 objectives for vaccination of older adults.

National Adult Immunization Awareness Week is held in October each year. This week emphasizes the importance of vaccinating adults against influenza, pneumococcal disease, hepatitis B, diphtheria, tetanus, measles, mumps, rubella, and varicella.

Additional information about National Adult Immunization Awareness Week is available from:

The National Coalition for Adult Immunization
4733 Bethesda Ave. Suite 750
Bethesda, MD 20814
Telephone (301) 656-0003; Fax (301) 907-0878
E-mail adultimm@aol.com
For further information about adult vaccination levels:

Behavioral Risk Factors for Disease and Injury in Mahoning County Adults: 1993 Survey Results. Mahoning County General Health district board of Health, 1993.

CDC. Pneumococcal and influenza vaccination levels among adults aged > 65 years - United States, 1993. MMWR1996;45:853-9
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