Adult Vaccination Coverage Varies Widely By State

Adult vaccination coverage may be impacted by state policies and other local factors, according to a recent study, which found significant heterogeneity between states in adherence rates.

In their retrospective analysis, the researchers examined data from the Behavioral Risk Factor Surveillance System. They identified individual factors associated with vaccination, including socio-demographics, health status, healthcare utilization, and state of residence. Using logistic regression, the researchers calculated the adjusted vaccination coverage for influenza, pneumococcal, herpes zoster (HZ), and tetanus, diphtheria, acellular pertussis (Tdap), and estimated adherence to these vaccines both nationally and by state.
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Factors consistently associated with adherence to all 4 vaccines included female sex, higher levels of education, and annual household income.

The model-adjusted vaccination coverage estimates were found to vary widely by state, ranging from 30.2% to 49.5% for influenza among adults aged 18 years and older, 64% to 74.7% for pneumococcal among adults aged 65 years and older, 18.7% to 46.6% for Tdap among adults aged 18 years and older, and 21.3% to 42.9% for HZ among adults aged 60 years and older.

Additionally, the model-adjusted adherence based on age-appropriate recommendations was low and varied by state, ranging from 7.9% to 24.7% for influenza and Tdap, 4.1% to 14.4% for influenza, Tdap and HZ, and 3% to 18.3% for influenza, Tdap, HZ, and pneumococcal.

“In summary, after adjusting for individual characteristics associated with vaccination, substantial heterogeneity across states remained, suggesting that other local factors (e.g. state policies) may be impacting adult vaccines uptake,” the researchers concluded. “Further research is needed to understand such factors, focusing on differences between states with high versus low vaccination coverage.”

—Melissa Weiss

Reference:

LA EM, Trantham L, Kurosky SK, Odom D, Aris E, Hogea C. An analysis of factors associated with influenza, pneumoccocal, Tdap, and herpes zoster vaccine uptake in the US adult population and corresponding inter-state variability [published online December 1, 2017]. Hum Vaccin Immunother. https://doi.org/10.1080/21645515.2017.1403697.