Institute for Health and Aging

The Centers for Disease Control and Prevention (CDC) estimate that influenza causes 36,000 deaths in the United States every year, and results in direct medical care costs of over $4.6 billion annually. Influenza and pneumonia are responsible for 8,800 deaths per year in California alone, making it the sixth leading cause of death among adults in the state, yet the illnesses are largely preventable by immunization.

The California Adult Immunization Coalition (CAIC) is comprised of more than 20 organizations across California who are working together to increase immunization rates for influenza and pneumonia in adults. The CAIC analyzed influenza vaccination rates in California using data from the 2001 California Health Interview Survey (CHIS), and compared the results to the national Healthy People 2010 goals for adult immunization. The national goals specify that 90% of older adults (age 65 and over) should be immunized against influenza annually by the year 2010 (i.e., less than 10% should remain unimmunized).

To deepen our understanding of this important public health issue, the CAIC has added several specific questions concerning adult immunizations to the 2003 CHIS survey. Results of this most recent survey will be available next year. Increasing California’s adult immunization rates to reach the national goal requires the persistent efforts of multiple sectors including vaccine suppliers, health departments, and individual health clinics and health providers’ offices.

Key findings are:

• 32.6% of older adults (age 65 and over) in California for whom annual flu shots are recommended did not get immunized in 2001. • Immunization rates among older adults varied by region; rates were found to be lowest in the Los Angeles region (63.9%) and highest in the Sacramento region (77.0%). However, no regions in California came close to meeting the national goal that 90% of older adults be immunized against influenza. • Although there was a strong age-related trend for the elderly to get an influenza immunization, 27% remained unimmunized even among people aged 75 years and over. • Among the state’s racial and ethnic groups, Latinos (46%) and African Americans (47%) over the age of 65 were almost twice as likely to go unimmunized when compared with Asians (27%) and Whites (28%) in the same age group. • Persons with a "medical home" (a regular place to get medical care) were more than twice as likely to get immunized compared to those who did not have a usual source of care. • The more often an individual saw the doctor, the more likely he or she was to get a flu shot, however, large numbers of people with regular access to care were still unimmunized. • Patients covered by Medicare were immunized more often than those who were not covered; in the Medicare-covered group 32.7% were not immunized. • There were no differences found in immunization rates between women and men.