Characteristics of community dwelling elderly not vaccinated for pneumococcus in 1998 and 2001.
BACKGROUND
We estimate proportions and numbers of elderly (>65 years old) not vaccinated for pneumococcus in 1998 and 2001 by ethnic group, socioeconomic status, health history, and access and use of health care.


METHODS
Self-reported lifetime pneumococcal vaccination and participant characteristics were obtained from 10,624 community dwelling elderly in the 1998 and 2001 National Health Interview Surveys (NHIS). Robust descriptive and inferential statistical analyses were fit. Outcome. Non-receipt of pneumococcal vaccination.


RESULTS
In 2001, about 13 million (or 45% of all) community dwelling elderly were unvaccinated against pneumococcus, including 11.5 million who saw a doctor at least once, 4 million who received an influenza vaccination and 2.3 million who were hospitalized, during the previous year. In 1998 and 2001 non-US born, Hispanic, African-American, and Medicaid recipient elderly were disproportionately un-vaccinated, with about 65% of each group not vaccinated in 2001.


CONCLUSIONS
In 2001, lifetime pneumonia vaccination of community dwelling elderly (55%) was below the goal (60%) for Healthy People 2000. While there has been important progress in improving overall vaccination rates, much more needs to be done to attain national goals and reduce large, persistent racial/ethnic and socioeconomic disparities. Lack of a usual source of healthcare and lower frequency of physician visits were among the factors associated with non-vaccination. However, most unvaccinated individuals had seen a physician in the last year, and many had received influenza vaccination or been hospitalized, suggesting the need for more consistent implementation and monitoring of guidelines for routine pneumococcal vaccination in healthcare settings.
Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ 08901, USA. drhoover@stat.rutgers.edu
Donald R
DR
Hoover
Usha
U
Sambamoorthi
Stephen
S
Crystal
D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003153:Community Health Services; D016001:Confidence Intervals; D005260:Female; D015577:Geriatric Assessment; D006306:Health Surveys; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration; D015994:Incidence; D008297:Male; D009515:New Jersey; D016017:Odds Ratio; D010349:Patient Compliance / Q000706:statistics & numerical data; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D011018:Pneumonia, Pneumococcal / Q000517:prevention & control*; D011237:Predictive Value of Tests; D011336:Probability; D012111:Residence Characteristics; D012189:Retrospective Studies; D018570:Risk Assessment; D014611:Vaccination / Q000706:statistics & numerical data*
D022242:Pneumococcal Vaccines