Public Release: 

Adults with asthma fail to follow flu vaccine guidelines

Age, education level major factors for vaccination rates in adult asthmatics

American College of Chest Physicians

(NORTHBROOK, IL, September 8, 2003) - Adults with asthma are considered a high risk group for developing complications after contracting the influenza virus, yet the majority of adults with asthma does not receive an annual influenza vaccination, says a study published in the September issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP). The study found that only one-third of all asthmatic adults and one-fifth of asthmatic adults under age 50 follow the Centers for Disease Control and Prevention guidelines that recommend asthmatics receive the influenza vaccine annually. The study also found that despite similar recommendations from the 1997 National Asthma Education and Prevention Program guidelines, the vaccination rate among adults with asthma has not improved from 1999-2001.

"Upper respiratory infections like influenza are an important trigger of asthma. Vaccination guidelines for asthmatics were established to help reduce the severe impact influenza can have on patients in this group," said study author Seymour G. Williams, MD, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia. "Initially, vaccination campaigns were aimed at older adults who are more likely to acquire a high risk health condition. The older age groups were easier to target and deliver the influenza vaccinations. It is harder to target and increase vaccination rates among groups younger than 65 years of age with high risk conditions including asthma, hence the overall influenza vaccination rates among persons with asthma are less than optimal."

Researchers from the National Center for Environmental Health, Centers for Disease Control and Prevention, utilized data from the National Health Interview Survey from 1999-2001 to examine the prevalence of influenza vaccinations among people with asthma. A sample of the United States population participated in the study each year, including 30,801 in 1999, 32,374 in 2000, and 33,326 in 2001. Among respondents with asthma, those who reported receiving the influenza vaccine included 35.1 percent in 1999, 36.7 percent in 2000, and 33.3 percent in 2001. In respondents without asthma, percentages were significantly lower with 27.9 percent, 28.0 percent, and 25.9 percent reporting vaccination in the respective years. Survey results also indicated the percentage of respondents with asthma who reported being vaccinated increased strongly with age. In asthmatics age 18 to 49 years, those who reported being vaccinated included 20.9 percent in 1999, 22.7 percent in 2000, and 21.1 percent in 2001. Percentages rose to 46.2 percent, 47.8 percent, and 42.3 percent in respondents with asthma age 50 to 64 years, and 72.8 percent, 71.2 percent, and 64.8 percent in those 65 years and older.

"Improving vaccination rates in adults with asthma is challenging. In young adults with asthma, there is a misconception that the vaccination will aggravate their asthma, which may cause them to avoid being vaccinated. Others may avoid the vaccination due to the cost or simply because they do not see its benefits. In addition, health care providers may be unaware of the recommendations related to vaccinations in asthmatic patients," said Dr. Williams. "The consistently low vaccination rates suggest that various strategies, including education, aimed at the provider and patient are needed to address the concerns that people with asthma have about the vaccine and to share with the patient the proven benefits of annual influenza vaccinations."

In regard to demographics, survey results indicated that vaccination rates progressively increased with higher educational attainment and that gender and ethnicity impacted vaccination rates. In 2000, men were less likely to report having been vaccinated than women, and African-American participants were less likely to report having been vaccinated than white participants. In 2001, Hispanic participants were significantly less likely to report having been vaccinated than white participants.

"Respiratory infections such as influenza are more serious in patients with asthma and can often lead to adverse health outcomes, including pneumonia and acute respiratory disease," said Udaya B. S. Prakash, MD, FCCP, President of the American College of Chest Physicians. "To ensure effective asthma management, it is important for physicians to understand the current vaccination recommendations for asthmatic patients and educate patients on the importance of receiving their annual vaccination."

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CHEST is a peer-reviewed journal published by the ACCP. It is available on-line each month at http://www.chestjournal.org. ACCP represents more than 15,000 members who provide clinical, respiratory, and cardiothoracic patient care in the United States and throughout the world. ACCP's mission is to promote the prevention and treatment of diseases of the chest through leadership, education, research, and communication.

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