Influenza Survey Shows 'Sobering' Results

Fewer than one-third of U.S. adults surveyed in a nationwide poll had been vaccinated against seasonal influenza as of mid-November, and more than half of those remaining said they had no intention of getting the vaccine.

"There are opportunities for improvement here," said William Schaffner, M.D., president-elect of the National Foundation for Infectious Diseases, which hosted a Dec. 10 teleconference on results of the study conducted by the Rand Corp. "This is the big result of this survey. Frankly, I found it somewhat sobering. It looks as if we have to do much better, and the message has not gotten out very well."

Katherine Harris, Ph.D., an economist with Rand Corp., said the midseason report marked the first time influenza vaccine uptake data have been available this early in the season.

The results weren't good.

According to the CDC, 70 percent of American adults are covered by one or more of the agency's indications for receiving influenza vaccination, meaning they are age 50 or older, a health care worker, a caregiver to children or the elderly, or have a high-risk health condition. However, among survey respondents, only 37 percent of adults in these categories had been vaccinated as of mid-November. Among respondents age 50 and older, fewer than half had been vaccinated, and 34 percent said they did not intend to get vaccinated.

In addition, although 52 percent of respondents with heart disease, chronic lung disease or diabetes had been vaccinated, more than 20 percent of respondents in each of these three groups said they would not get vaccinated. Only one-third of respondents with asthma had been vaccinated, and more than one-half said they had no intention of getting vaccinated.

"That is still significant morbidity, and potentially mortality, that could be avoided if we reach those (people)," said Litjen Tan, Ph.D., co-chair of the National Influenza Vaccine Summit and director of infectious diseases, immunology and molecular medicine for the AMA. "It points again to the fact that we have some outreach we need to do with people who have high-risk conditions."

The study found that 41 percent of respondents who had not yet gotten vaccinated cited inadequate free time as a reason for not being vaccinated. Respondents also said they

Among respondents who had no intention of receiving the vaccine, reasons included

Vaccination needs to be a higher priority among the public, said Tan. "We need to figure out a way to increase the awareness of the severity of influenza as a disease."

More than 15 million Americans suffer from influenza each year, he noted, leading to about 226,000 hospitalizations and 36,000 deaths. In addition, influenza costs the U.S. economy about $10 billion in lost productivity annually, according to Tan.

Despite those staggering numbers, people aren't running out to get the vaccine, even if their medical conditions indicate that they should, according to the survey.

Some respondents, who were lumped into a group of people who offered "other" reasons for not being vaccinated, said their physicians had not recommended it.

"That comes back to us," Schaffner said. "The most important reason many people do get vaccinated is that their health care provider -- their physicians, nurse practitioner, physician assistant, whoever -- actually made a strong recommendation that they should be vaccinated. I think the health care profession needs to hear that."

Schaffner reiterated the message that physicians should continue to offer vaccinations through December and January because influenza typically peaks in February.

Continuing to offer immunizations throughout the winter also could help physicians avoid having leftover vaccine. The AAFP's 2008 immunization survey found that 44.1 percent of respondents had leftover vaccine after the 2007-08 influenza season. Of those, 62.3 percent said they had as much as 10 percent of their supply remaining, and 18 percent had 11 percent to 20 percent of their supply left over.