Adults with Asthma Not Getting Their Flu Shots

At-Risk Population Under Vaccinated

San Diego, CA, 22 June 2009 – 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.”

The article is “Influenza Vaccination Among Adults with Asthma: Findings from the 2007 BRFSS Survey” by Peng-jun Lu, MD, PhD, Gary L. Euler, DrPH, and David B. Callahan MD. It appears in the American Journal of Preventive Medicine, Volume 37, Issue 2 (August 2009) published by Elsevier.

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About The American Journal of Preventive Medicine
The American Journal of Preventive Medicine is the official journal of The American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women's health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials.

The American Journal of Preventive Medicine is ranked 12th out of 100 Public, Environmental & Occupational Health titles and 16th out of 100 General and Internal Medicine titles according to the 2008 Journal Citation Reports© published by Thomson Reuters.

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