As Elderly Population Increases, the Toll of Influenza and Pneumonia Will Likely Rise

The American Lung Association released its latest health disparity report today, "Missed Opportunities: Influenza and Pneumonia Vaccination in Older Adults," in an effort to eliminate disparities in influenza and pneumonia vaccination rates among older Americans. The Lung Association is focusing on this disparity because despite the ready availability of safe and effective vaccines, millions of people over 65 are not being vaccinated, especially older African Americans and Hispanics, who are at increased risk from these preventable, yet deadly, respiratory diseases.

Influenza is responsible for an average of 226,000 hospitalizations and anywhere from 3,000 to 49,000 deaths annually. Nearly 90 percent of deaths occur among people 65-years of age and older. Studies show that the flu shot can be up to 70 percent effective in preventing hospitalizations for both influenza and pneumonia in those over 65.

"The American Lung Association appreciates the U.S. Department of Health and Human Services' attention to this important subject with its recognition of today as National Influenza Vaccination Week's Older Adults Vaccination Day," says Jim Gooden, national volunteer chair of the American Lung Association. "Working together, we can ensure that more and more seniors get vaccinated, especially African Americans and Hispanics over age 65, who are unfortunately receiving vaccinations at significantly lower rates than whites."

In fact, African Americans and Hispanics are 28 percent and 25 percent less likely than whites to receive an influenza vaccination. The disparity is even more prominent for pneumonia vaccinations as African Americans and Hispanics are 37 percent and 47 percent less likely to receive the vaccine than whites. Unfortunately, these groups are disproportionately at risk of having preexisting conditions such as asthma, heart disease and diabetes that further increases the risk of severe illness and death from influenza and pneumonia.

More alarming is that these disparities exist despite older adults of all racial and ethnic groups accessing healthcare at roughly the same rate. Somehow, in healthcare settings, many older adults are not getting vaccinated. The core of the problem is that some patients are not asking to be vaccinated, and some doctors are not recommending it when seeing patients.

It has been suggested that if older African Americans and Hispanics achieved immunization rates equal to that of whites, roughly 25 percent of flu-related deaths among these groups could be prevented every year.

"This is a ticking time bomb. As baby boomers age, and the nation's elderly population rises, the toll of influenza and pneumonia will likely increase," said Gooden continued. "It's important that we address this health disparity now to prevent serious illness and save lives in the future."

The Lung Association's report highlights some possible reasons behind this disparity and proposes a series of public health and policy solutions to bring parity to overall vaccinations rates among older Americans. These reasons are multiple, complex and interrelated and include internal barriers within healthcare systems, provider beliefs and behaviors, patient knowledge awareness and personal beliefs, along with affordability and access to care.

The American Lung Association also calls on federal and state government agencies, healthcare systems and individual providers and practices to take the following actions to close the gap of missed vaccination opportunities:

- Implement policies that ensure influenza and pneumonia vaccinations for all adults at no cost.

- Continue annual vaccination campaigns to remind older adults and healthcare providers of the risks of influenza and pneumonia, current recommendations for and the benefits of vaccination. All vaccination campaigns should use targeted, culturally-appropriate messages and messengers to reach under-served communities.

- Ensure that health providers and workers coming into contact with patients get vaccinated.

- Coordinate and streamline the vaccine management process to ensure that vaccines are readily available.

- Include people of all ages in State Immunization Information systems.

- Establish systems in medical practices to effectively track patient vaccination status.

- Implement standing orders for appropriate vaccinations for all patients every year to reduce the likelihood of spreading disease

- Encourage community leaders to serve as role models to dispel myths and promote the benefits of vaccination.

- Encourage families to make sure that everyone gets the influenza and pneumonia vaccines as recommended: vaccinating the young helps protect the old as well.

For a copy of the report, visit www.lungusa.org/vaccination-disparities