WASHINGTON, July 22 // -- Young adults may have grown up in an era of information overload, but they have alarmingly little awareness of the risks of vaccine-preventable diseases and the need to keep up with vaccinations into adulthood, new data show.
For example, 84 percent of Americans over the age of 50 know that tetanus causes lockjaw and that they need to get a tetanus shot every 10 years. By contrast, just 49 percent of young adults aged 18 to 26 are aware of that fact, according to a survey commissioned by the National Foundation for Infectious Diseases (NFID).
"Unless all adults, and young adults in particular, get more savvy and keep up with recommended immunizations, the nation could be vulnerable to outbreaks of vaccine-preventable disease down the road," warned William Schaffner, MD, president-elect of NFID and chairman of the Department of Preventive Medicine at Vanderbilt University, at a news conference attended by top U.S. public health officials and other medical experts. All underscored the importance of vaccination throughout the lifespan of an individual, not just in childhood.
Experts say that overall lack of awareness and knowledge among adults runs parallel to lower vaccination levels. According to the latest National Health Interview Survey (NHIS) released by the U.S. Centers for Disease Control and Prevention (CDC), while we are seeing positive movement in some adult vaccination levels, rates still lag behind national targets across the board.
"Just as we prioritize protecting children with vaccines, we must also prioritize vaccination of adults as part of optimal preventive care," said Assistant U.S. Surgeon General and director of the National Center for Immunization and Respiratory Diseases Anne Schuchat, MD. "Adult immunization saves lives, prevents illness and will help us rein in the cost of healthcare by keeping the nation healthy."
NFID's medical director, Susan J. Rehm, MD, vice chair of the Department of Infectious Disease at the Cleveland Clinic, unveiled the NFID survey data showing that fewer than half of all American adults are "extremely or very familiar" with a number of vaccine-preventable diseases that can cause severe illness or death. To highlight this, just 20 percent of those surveyed were aware of pneumococcal disease, a vaccine-preventable disease that kills up to 4,500 adults in the U.S. every year.
Of special concern, experts said, is the lack of knowledge and awareness among young adults aged 18 to 26. For example, just 30 percent of young adults know that flu, which can be prevented with a vaccine, kills more Americans than any other vaccine-preventable disease. By contrast, 59 percent of adults over the age of 50 are aware of that fact, the survey found.
"This pattern is not surprising," said Dr. Rehm. "Our childhood vaccination program is so successful that adolescents cross into young adulthood having been extremely well protected against vaccine-preventable diseases and therefore have little or no personal experience with them. This may signal trouble in the future. As these young adults go on to have their own families, if they don't realize the importance of getting vaccinated for themselves, they may not prioritize it for their children either. That could make outbreaks of many vaccine-preventable diseases possible again."
NFID, which has long advocated for optimal use of all vaccines recommended by public health officials, has embarked on a campaign to raise public awareness about the need for adults - including young adults - to keep up with immunizations after childhood. (For a list of diseases and vaccines, go to www.adultvaccination.org.)
Adult Vaccination Levels Lag
The latest data from CDC show that there are still too few Americans taking advantage of vaccines recommended to protect them from infectious diseases. Influenza and pneumococcal vaccination levels remain at 66.6 percent and 60 percent, respectively, for those over age 65. Other adult vaccination levels are lower - 6.7 percent for shingles in those 60 and older; about 10 percent for human papillomavirus (HPV) vaccine in women 19 to 26 years of age and about 15 percent for Tdap in those 19 to 64 years of age.
It should be noted that Tdap booster is recommended in place of one tetanus-diphtheria (Td) booster vaccine, which is recommended every 10 years. Since Tdap has only been licensed since June 10, 2005, a substantial portion of the population has not yet reached the 10-year timing milestone since their last Td vaccine. The coverage level for any Td-containing vaccine is 64 percent for those 19 to 49 years of age, 63 percent for those 50 to 64 years of age and 52 percent for those 65 and older.
While influenza and pneumococcal vaccination levels are highest and have remained somewhat steady, these rates are disappointing, because influenza and pneumococcal vaccines have long been a part of the adult schedule and the coverage goal is 90 percent. Also of concern are racial and ethnic disparities in coverage levels in people 65 and older. Influenza coverage level in non-Hispanic whites in this age group is above the national average at 69 percent, while the rates for non-Hispanic blacks and Hispanic persons 65-plus are well below at 53 percent and 51 percent, respectively. Similarly, for pneumococcal disease, whites 65-plus have higher coverage levels than non-Hispanic blacks and Hispanics at 64 percent, 44 percent and 36 percent, respectively.
"Immunity is a lifetime continuum and should be the goal for all adults as part of good preventive care and wellness," said Dr. Schuchat. "We need to make a strong, long-term commitment to adult immunization as a nation if we are to realize the full benefits of the many vaccines available to us."
While the NFID-sponsored survey found that most adults were very familiar with flu and chickenpox, both of which can be prevented by vaccines, it found that most adults were not very familiar with a host of other infectious diseases that can be prevented with vaccines. In addition to pneumococcal disease, these include shingles, hepatitis B, pertussis and HPV, which causes cervical cancer.
Although young adults were more likely than older adults to be very familiar with HPV and pneumococcal disease, they were much less likely than older adults to be aware of the threat from other vaccine-preventable diseases.
Physicians Have Most Influence Over Whether Adults Are Vaccinated
The survey found that personal physicians had the most influence on whether adults are aware of vaccine-preventable diseases and whether they keep up with their vaccinations, and that people who get annual physical exams are more likely to be vaccinated than those who don't visit their doctor every year.
At the news conference, Stanley A. Gall, MD, professor of obstetrics, gynecology and women's health at the University of Louisville, said that OB-GYN doctors could play an important role in making sure that the women they see are up-to-date with vaccinations. "Women may not only make better decisions about their own immunity based on input from an OB-GYN, but they may also bring immunization messages home to other family members," he said.
Robert H. Hopkins, MD, associate professor at the University of Arkansas for Medical Sciences, called for stepped-up attention to the fact that adults need to take a more active role in good preventive care, which includes getting vaccinated. "Mid-life is a time when people typically begin to face new health hazards, such as obesity and diabetes, and are therefore more vulnerable to the infectious diseases that vaccines can prevent. But even if middle-aged people are otherwise healthy, vaccines are an essential component of continued good health," he said.
Cora L. Christian, MD, a member of AARP's Board of Directors stressed the importance of vaccinating 50-plus Americans, particularly those who care for children and older loved ones. "The sandwich generation of Americans who may provide care for both their children and older parents are particularly vulnerable to infectious diseases," Christian said. "It's critical for caregivers and anyone 50-plus to get annual influenza vaccinations so they can avoid getting sick and prevent the spread of flu to their families. Just as important, people 65 and older should ask their doctor about a pneumococcal vaccine."
The NHIS has monitored the health of the nation since 1957. NHIS 2008 data were collected through interviews with approximately 29,000 households.
The NFID survey, conducted by Opinion Research Corporation, was based on telephone interviews with 1,001 Americans aged 18 and older Feb. 19-22, 2009. The margin of error is plus or minus 3 percent.
About the National Foundation for Infectious Diseases
The National Foundation for Infectious Diseases (NFID), a non-profit organization, has been a leading voice for education about infectious diseases and vaccination since 1973. It is dedicated to educating the public and healthcare professionals about the causes, treatment, and prevention of infectious diseases. For more information on vaccines and vaccine-preventable diseases, please visit www.nfid.org.
This news conference is sponsored by the National Foundation for Infectious Diseases and supported by unrestricted
educational grants from GlaxoSmithKline, Merck & Co., Inc., sanofi pasteur and Wyeth Pharmaceuticals.