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Cited by 442Vaccine Coverage and HesitancyCervical Cancer and HPV ResearchIntramuscular injections and effects

Surveillance of vaccination coverage among adult populations—United States, 2015.

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Williams, Walter W., Lu, Peng-Jun, O’Halloran, Alissa, Kim, David K., Grohskopf, Lisa A., Pilishvili, Tamara, Skoff, Tami H., Nelson, Noele P. +4 more·2017·MMWR Surveillance Summaries
DOI 10.15585/mmwr.ss6611a1PMC PMC5829683
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Abstract

PROBLEM/CONDITION: Overall, the prevalence of illness attributable to vaccine-preventable diseases is greater among adults than among children. Adults are recommended to receive vaccinations based on their age, underlying medical conditions, lifestyle, prior vaccinations, and other considerations. Updated vaccination recommendations from CDC are published annually in the U.S. Adult Immunization Schedule. Despite longstanding recommendations for use of many vaccines, vaccination coverage among U.S. adults is low. PERIOD COVERED: August 2014-June 2015 (for influenza vaccination) and January-December 2015 (for pneumococcal, tetanus and diphtheria [Td] and tetanus and diphtheria with acellular pertussis [Tdap], hepatitis A, hepatitis B, herpes zoster, and human papillomavirus [HPV] vaccination). DESCRIPTION OF SYSTEM: The National Health Interview Survey (NHIS) is a continuous, cross-sectional national household survey of the noninstitutionalized U.S. civilian population. In-person interviews are conducted throughout the year in a probability sample of households, and NHIS data are compiled and released annually. The survey objective is to monitor the health of the U.S. population and provide estimates of health indicators, health care use and access, and health-related behaviors. RESULTS: Compared with data from the 2014 NHIS, increases in vaccination coverage occurred for influenza vaccine among adults aged ≥19 years (a 1.6 percentage point increase compared with the 2013-14 season to 44.8%), pneumococcal vaccine among adults aged 19-64 years at increased risk for pneumococcal disease (a 2.8 percentage point increase to 23.0%), Tdap vaccine among adults aged ≥19 years and adults aged 19-64 years (a 3.1 percentage point and 3.3 percentage point increase to 23.1% and to 24.7%, respectively), herpes zoster vaccine among adults aged ≥60 years and adults aged ≥65 years (a 2.7 percentage point and 3.2 percentage point increase to 30.6% and to 34.2%, respectively), and hepatitis B vaccine among health care personnel (HCP) aged ≥19 years (a 4.1 percentage point increase to 64.7%). Herpes zoster vaccination coverage in 2015 met the Healthy People 2020 target of 30%. Aside from these modest improvements, vaccination coverage among adults in 2015 was similar to estimates from 2014. Racial/ethnic differences in coverage persisted for all seven vaccines, with higher coverage generally for whites compared with most other groups. Adults without health insurance reported receipt of influenza vaccine (all age groups), pneumococcal vaccine (adults aged 19-64 years at increased risk), Td vaccine (adults aged ≥19 years, 19-64 years, and 50-64 years), Tdap vaccine (adults aged ≥19 years and 19-64 years), hepatitis A vaccine (adults aged ≥19 years overall and among travelers), hepatitis B vaccine (adults aged ≥19 years, 19-49 years, and among travelers), herpes zoster vaccine (adults aged ≥60 years), and HPV vaccine (males and females aged 19-26 years) less often than those with health insurance. Adults who reported having a usual place for health care generally reported receipt of recommended vaccinations more often than those who did not have such a place, regardless of whether they had health insurance. Vaccination coverage was higher among adults reporting one or more physician contacts in the past year compared with those who had not visited a physician in the past year, regardless of whether they had health insurance. Even among adults who had health insurance and ≥10 physician contacts within the past year, depending on the vaccine, 18.2%-85.6% reported not having received vaccinations that were recommended either for all persons or for those with specific indications. Overall, vaccination coverage among U.S.-born adults was higher than that among foreign-born adults, with few exceptions (influenza vaccination [adults aged 19-49 years and 50-64 years], hepatitis A vaccination [adults aged ≥19 years], and hepatitis B vaccination [adults aged ≥19 years with diabetes or chronic liver conditions]). INTERPRETATION: Coverage for all vaccines for adults remained low but modest gains occurred in vaccination coverage for influenza (adults aged ≥19 years), pneumococcal (adults aged 19-64 years with increased risk), Tdap (adults aged ≥19 years and adults aged 19-64 years), herpes zoster (adults aged ≥60 years and ≥65 years), and hepatitis B (HCP aged ≥19 years); coverage for other vaccines and groups with vaccination indications did not improve. The 30% Healthy People 2020 target for herpes zoster vaccination was met. Racial/ethnic disparities persisted for routinely recommended adult vaccines. Missed opportunities to vaccinate remained. Although having health insurance coverage and a usual place for health care were associated with higher vaccination coverage, these factors alone were not associated with optimal adult vaccination coverage. HPV vaccination coverage for males and females has increased since CDC recommended vaccination

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  • Vaccination coverage among the majority of adult populations at high risk aged ≥30 years has remained low; these groups account for the highest rates of preventable acute infections.

    “In contrast, vaccination coverage among the majority of adult populations at high risk aged ≥30 years (e.g., persons with multiple sex partners, MSM, and injecting drug users) has remained low (1320,1321); these groups account for the highest rates of preventable acute infections (12,1319,1322).”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [1320]

    The Introduction and Abstract > Interpretation report that adult vaccination coverage remains low, supporting the general point. But the Methods > Data Source and Collection describe hepatitis B risk data for travelers and people with diabetes or chronic liver disease, not coverage specifically among adults aged ≥30 years with multiple sex partners, MSM, or injection drug use. The sentence cites other sources for the separate claim about rates of preventable acute infections. (LLM, conf=0.84)

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Research works printed but not linked: 3

  1. [61]Chesson H, Markowitz L. The cost effectiveness of quadrivalent human papillomavirus vaccination of females over age 12 years in the United States. In: Alary M, ed. Proceedings of the 19th conference of the International Society for STD Research (Quebec City, Canada); July 10–13, 2011; Bologna, Italy: Medimond, 2011:19–22.
  2. [89]Joon Lee T, Hayes S, Cummings DM, Herpes zoster knowledge, prevalence, and vaccination rate by race. J Am Board Fam Med 2013; 26: 45– 51. 10.3122/jabfm.2013.01.120154 23288280 · DOI
  3. [118]CDC. Influenza vaccination among pregnant women, the 2011–12 season. MMWR Morb Mortal Wkly Rep 2012; 61: 758– 63. 23013721

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Authors
Williams, W. W., Lu, P.-J., O’Halloran, A., Kim, D. K., Grohskopf, L. A., Pilishvili, T., Skoff, T. H., Nelson, N. P., Harpaz, R., Markowitz, L. E., Rodriguez-Lainz, A., & Fiebelkorn, A. P.
Affiliations
  • National Center for Immunization and Respiratory Diseases (US)
  • Leidos (United States) (US)
  • National Center for HIV/AIDS Viral Hepatitis STD and TB Prevention (US)
  • Division of Global Migration and Quarantine, National Center for Emerging and Zoonotic Infectious Diseases, CDC
Corresponding author
Williams, Walter W.
ORCID
Venue
MMWR Surveillance Summaries
Publisher
Centers for Disease Control MMWR Office
Published
2017-05-05
Volume
66
Issue
11
Pages
1-28
ISSN
  • 1545-8636 (ISSN-L)
  • 1546-0738
DOI
10.15585/mmwr.ss6611a1
PMC
PMC5829683
OpenAlex
W2272632494
Cited by
442
References
113
Citations by year
2026: 12 · 2025: 9 · 2024: 17 · 2023: 28 · 2022: 43 · 2021: 66 · 2020: 50 · 2019: 87 · 2018: 96 · 2017: 23 · 2016: 1 · 2013: 2
FWCI
77.70
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • MMWR Surveillance Summaries (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Health › Vaccine Coverage and Hesitancy
  • Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
  • Health Sciences › Medicine › Emergency Medicine › Intramuscular injections and effects
Keywords
adult vaccination, influenza vaccination, pneumococcal vaccine, Tdap vaccine, herpes zoster vaccine, hepatitis B vaccine, hepatitis A vaccine, HPV vaccine, vaccine-preventable diseases, National Health Interview Survey, vaccine recommendations, healthcare workers, United States adults, vaccine uptake trends
MeSH terms
Adult, Aged, Female, Humans, Male, Middle Aged, Population Surveillance, United States, Vaccination, Vaccines, Young Adult

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