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Adults with Asthma Not Getting Their Flu Shots: At-Risk Population Under Vaccinated

22 June 2009 Elsevier

Because of increased risk of complications from influenza, vaccination of adults and children with asthma is recommended by the Advisory Committee on Immunization Practices. The Healthy People 2010 Objectives call for annual influenza vaccination of at least 60% of adults aged 18–64 years with asthma. However, Centers for Disease Control and Prevention (CDC) investigators have determined that the vaccination levels among asthma sufferers falls well short of this guideline. The results of their study are published in the August 2009 issue of the American Journal of Preventive Medicine.

The Behavioral Risk Factor Surveillance System (BRFSS) has been in use since 1984 and collects state-specific data from random telephone surveys of US adults. This study analyzed the responses of 173,572 adults aged 18–64 years and found that 8.4% had asthma. In the 2006–2007 influenza season, vaccination estimates ranged from 26.9% in California to 53.3% in Tennessee with a median across all states of 43.1%.

Influenza vaccination coverage was 33.9% for adults aged 18–49 years with asthma compared to 54.7% for adults aged 50–64 years with asthma. Among people aged 18–64 years without asthma, vaccination coverage was 28.8%. In addition, the researchers found a race/ethnicity gap of 8 to 10 percentage points between levels among non-Hispanic whites compared to levels among non-Hispanic blacks or Hispanics, despite adjustments for a set of socio-demographic and access-to-care variables.

Lead investigator Peng-jun Lu, National Center for Immunization and Respiratory Diseases, CDC, and co-investigators advise, “The National Asthma Education and Prevention Program identified influenza vaccination as one of several ‘key clinical activities that should be considered as essential for quality asthma care.’ The panel included influenza vaccination among the ‘core set of 10 key clinical activities’ to reducing asthma morbidity and mortality…. To further improve vaccination coverage among people with asthma, providers should address barriers to delivery and acceptance of influenza vaccination among those with high-risk conditions, including asthma. Providers should also be encouraged to use evidence-based immunization strategies (such as standing orders, patient reminder/recall, provider reminder, provider assessment and feedback); screen for asthma or other high-risk conditions; and routinely offer influenza vaccination.”

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