Vaccination Coverage Among Adults Aged 65 and Over: United States, 2015

Questions for Tina Norris, Ph.D., Health Statistician and Lead Author of “Vaccination Coverage Among Adults Aged 65 and Over: United States, 2015”

Q:  Why did you conduct this study?

TN:  We produced this report because vaccination is an important preventive health measure. Older adults have greater susceptibility to—and complications from—disease, and so they stand to benefit greatly from vaccinations as a preventive health measure. This study explores how the percentage of adults aged 65 and over, who received these recommended vaccinations, varied by sex, age group, race/ethnicity, and poverty status.

Q: What finding in your new study most surprised you and why?

TN:  While not unexpected, it was quite striking to see the overall variation in rates by vaccination type. We observed quite a range in the rates of vaccine coverage for influenza, pneumococcal disease, tetanus, and shingles. For example, more than two-thirds of adults aged 65 and over had an influenza vaccine in the past 12 months, while one-third had ever had a shingles vaccine.

Q:  Your report indicates you’ve examined receipt of vaccinations among community-dwelling adults aged 65 and over. What do you mean by “community-dwelling adults?”

TN:  By community-dwelling, we mean those individuals who are not living in any type of institutional setting (ex. nursing homes, hospitals, etc.).

Q:  What differences did you see among race and ethnic groups, and between the sexes?

TN:  We did see a number of significant differences in vaccination coverage among race groups and between the sexes. In terms of race, Non-Hispanic white adults were more likely than Hispanic and non-Hispanic black adults to have had an influenza vaccine in the past 12 months. Non-Hispanic white adults were more likely than Hispanic, non-Hispanic black, and non-Hispanic Asian adults to have had a tetanus vaccine in the past 10 years or to ever have had a vaccination for pneumococcal disease or shingles.

Vaccination also varied by sex. Among adults aged 65 and over, men were more likely than women to have had a tetanus vaccine in the past 10 years. However, men were less likely than women to have had a shingles vaccine at some point in the past.

Q:  What would you say is the take-home message of this report?

TN:  I think the take-home message of this report is that many adults aged 65 and over are not receiving recommended vaccinations. For example, two-thirds of adults never had a shingles vaccine, and nearly one-half did not have a tetanus vaccine in the past 10 years. We also see gaps in coverage for all four vaccinations—influenza, pneumococcal, tetanus, and shingles—by sex, age group, race and ethnicity, and poverty status.

Q:  Did you look at any titer-level testing for adults prior to vaccination receipt as a factor in vaccination coverage?

TN:  While titer-level testing is an interesting component in the strength of a body’s immune response to disease, titer-level testing was out-of-scope for this project.

Q:  Did your survey look at the different Medicare types of insurance as a factor in vaccination coverage for the population you studied?

TN:  No, insurance coverage was not included due to the cross-sectional nature of the survey and the long recall period for some of the vaccinations.  However, direct costs—and when the cost is incurred for vaccinations—have been shown to vary according to insurance coverage, and have been linked to financial burden for older adults.