KEYWORD1:
Adult immunization, vaccine-preventable diseases, disparities, barriers to immunization, infrastructure

BACKGROUND:
Vaccine-preventable infectious diseases result in greater loss of life among adults than among children in the U.S. Although many appreciate the annual campaigns to promote influenza immunization of adults 50 years of age and older, few appreciate the value of being up-to-date on tetanus, diphtheria, hepatitis A and B, measles, mumps, rubella, varicella, pneumococcal or pneumococcal vaccines.

OBJECTIVE:
To characterize adult-relevant infectious diseases that can be prevented by vaccines and identify barriers to their use.

METHOD:
The incidence of certain vaccine-preventable diseases among adults >15 years of age were determined. Rates of use of tetanus, rubella, varicella, hepatitis B, influenza and pneumococcal vaccines among children and adults were examined. Reports identifying barriers to adult immunization were reviewed.

RESULT:
Current ACIP recommendations provide for vaccinating adults against ten infectious diseases. Nevertheless, adult cases of tetanus, rubella, varicella, and hepatitis B remain serious public health concerns. Use of vaccines against these and other diseases by adults is substantially less than the rates of use among children. Barriers to achieving greater use of adult-appropriate vaccines reflect limited public and provider knowledge about adult immunization, patterns of health care use by adults, economic constraints, absence of infrastructure and complex public health recommendations. These and other factors pose additional barriers to achieving greater use of vaccines among African American and Hispanic adults.

CONCLUSION:
Despite limitations related to disease and vaccination surveillance, vaccines are under utilized among adults, especially among minority populations. A variety of factors reflecting public and provider knowledge, economics and infrastructure constitute formidable, but surmountable barriers to increasing adult immunization rates.
LEARNINGOBJECTIVES:
Participants will be able to identify vaccine-preventable infectious diseases of adults, and discuss factors that limit adult use of disease preventing vaccines.