CONTACT: DAVE PEDERSEN
2130 Medical Laboratories
Iowa City IA 52242
(319) 335-8032; fax (319) 335-8034
Release: July 6, 1999
UI study indicates many older adults still not receiving
IOWA CITY, Iowa -- Many older adults still do not
receive flu and pneumococcal vaccinations despite their proven safety and
effectiveness in helping some elderly people-- especially those with chronic
medical conditions -- avoid more serious illness.
These findings come from University of Iowa Health
Care researchers who interviewed nearly 800 older Iowans to determine what
factors were associated with getting the vaccines.
"Vaccinations are one of the best preventive health
measures around, yet I'm always surprised that they are not more widely used,"
said Bradley Doebbeling, M.D., UI associate professor of internal medicine
and preventive medicine and environmental health, and the study's senior author.
"We were interested in finding out more about who's receiving their shots
among this specific segment of the population. I think our results show that
there is room for improvement."
The researchers studied 787 Iowa adults, selected
at random from both rural and urban areas, who were age 65 or older and who
had one or more chronic conditions such as arthritis, diabetes, heart or lung
disease, or hypertension. Participants were asked about their current health
practices, marital and occupational status, and access to health care.
Of the 784 subjects who provided complete influenza
vaccination information, 68 percent reported getting the flu vaccine in the
past year. Of the 768 people who provided complete pneumococcal vaccination
information, 51 percent reported having received it. Forty-four percent of
the study participants reported receiving both vaccines.
Doebbeling said the numbers are "certainly lower than
we'd like to see. This is a group of people who actually have two strong indicators
-- being age 65 or older and having a chronic health problem -- for getting
these vaccines. This is a group that we should be targeting for vaccination
in the 90 to 100 percent range," he said.
Study results showed that people age 70 or older were
more likely to get the vaccinations, as were those who were still married
or did not live on their own. Study participants age 65 or older who were
still working were more likely to be immunized, as were people who had more
contact with the medical system -- doctor visits,
prescription drug use or a number of underlying chronic illnesses. The researchers
found no significant disparities between rural and urban residents in the
study in terms of who had received the vaccines.
Insurance issues also affected whether study participants
received vaccinations. Since all of the study participants
were age 65 or older, they were all covered by Medicare. However, supplemental
insurance in addition to Medicare nearly doubled the likelihood of study participants
getting both vaccines. Doebbeling noted that Medicare coverage of the flu
vaccine apparently has resulted in an increase in its usage, and Medicare
coverage of the pneumococcal vaccine has only recently been provided.
Influenza and pneumococcal vaccinations have tremendous
benefits for older adults, Doebbeling said. Both vaccines have been around
for a number of years, are safe and have few, if any, side effects. Flu shots
among the elderly decrease mortality by about two-thirds if an older person
does get the flu. The flu vaccine is recommended yearly and for those who
get it every year there is even greater efficacy because the body has built
up antibodies to a panel of flu viruses. He added that the pneumococcal vaccine
helps prevent against a range of infections caused by Streptococcus pneumoniae.
In the United States these include about 3,000 cases of meningitis, 500,000
cases of pneumonia and nearly 7 million cases of ear infection each year.
The bottom line, Doebbeling said, is that both older
people and health care providers need to think about increased use of both
influenza and pneumococcal vaccines, particularly if a person is over 65 or
has a chronic condition. People should always be advocates for their own health
care and feel free to ask their physician about the vaccines.
"Physicians do a good job focusing on the patient's
immediate health complaints, but prevention issues do not always get covered,"
Doebbeling said. "These are simply missed opportunities. Hopefully, this study
will be a stimulus for both patients and providers to think about the benefit
that these vaccinations provide."
The UI study was published in the May issue of the
journal Medical Care.