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COPYRIGHT 2001 Consumers Union of the United States, Inc.
One of the public-health system's least known and most deplorable failings is this: Each year, some 40,000 Americans die of diseases that could have been prevented by routine adult vaccines. That's the same number that die from traffic accidents annually. And while sustained private and public support has made near-universal child immunization one of the shining medical success stories of the past century, adult immunization has languished in sometimes fatal neglect.
"Even most physicians don't realize that the vast majority of vaccine-preventable diseases--and deaths--occur in adults, not children," says William Schaffner, M.D., chairman of the department of preventive medicine at Vanderbilt University.
Interviews with vaccine experts and a review of statistics and studies of adult immunization show that widespread ignorance, complacency, and underfunding have converged to discourage--or, rather, fail to encourage--adult immunization against familiar but potentially deadly diseases such as influenza, pneumonia, hepatitis, and tetanus. (For a list of potentially serious diseases preventable by adult vaccines, see the table on page 51.)
Efforts to publicize adult vaccines are inadequate, officials at the Centers for Disease Control and Prevention (CDC) acknowledge. So the adults who need the shots often feel no urgency about getting them. "A lot of people think of influenza as something that just keeps you out of work for a few days," says Robert Hopkins, M.D., associate professor of medicine and pediatrics at the University of Arkansas for Medical Sciences. "They don't realize it's a killer that can, for example, wipe out 20 percent of the population of a nursing home."
Physicians do far too little to counter the ignorance and apathy. "Your dog's veterinarian and your auto mechanic probably do a better job of reminding you about preventive maintenance than your doctor does," notes James Singleton, acting chief of the adult vaccine-preventable disease branch of the National Immunization Program at the CDC.
The government's efforts fall far short as well. "It takes more than access to a vaccine to immunize a population," says Lance Rodewald, M.D., director of the immunization services division of the CDC's national program." It takes people going out to promote the vaccine. For adults, we don't have much of a program to do that."
UNDERCOVERED
Nine out of 10 American children have been immunized against dangerous diseases such as polio, measles, mumps, and whooping cough. By contrast, as of 1999 (the latest year for which statistics were available), only 54 percent of adults age 65 and over had ever received the vaccine that protects against pneumonia and other life-threatening diseases caused by pneumococcal bacteria. Yet the vaccine has been readily available for more than two decades and is recommended for everyone in that age bracket.
Even the best-known adult vaccine, the annual influenza shot, is greatly underused. Only two-thirds of adults age 65 and over receive the annual immunization, even though the vaccine is recommended for all of them.
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The figures for middle-aged and younger adults are even more dismal. According to the latest numbers, for 1998, only 31 percent of high-risk adults ages 18 to 64 had received the flu vaccine they needed, and a...
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