BACKGROUND:
ACIP recommended that adults aged 50 to 64 years receive an annual influenza immunization. The San Diego County Immunization Program conducted population-based random digit dialing telephone surveys to gather baseline information on the coverage levels, attitudes, barriers and sources of information.

OBJECTIVE:
Establish and monitor immunization coverage levels for adults aged 50 to 64 years in San Diego County. Identify possible strategies for improving immunization levels.

METHOD:
During the month of June 2003, interviews were completed with 731 adults aged 50 to 64 using the random digit dialing telephone survey methodology.

RESULT:
Thirty-six percent of respondents reported one or more chronic medical conditions. Based on self-report, the coverage level for receiving a flu vaccine in the last 12 months was 45.5%. Fifty-seven percent of those with chronic medical conditions and 39% of those without chronic medical conditions, respectively, received influenza vaccines. Respondents aged 50 to 64 years were much less likely to report influenza vaccines than those aged 65 and over (OR= 0.28, C.I.=0.22-0.35). Sixty-two percent of respondents think they should get an annual flu shot. The most significant prompt for obtaining the influenza immunization is receiving a doctor’s recommendation/routine care visit.

CONCLUSION:
The flu vaccine coverage level is low for this group, which has an elevated prevalence of chronic medical conditions. Additional resources must be identified in order to develop adult initiatives and implement appropriate adult immunization interventions. Based on this survey, evidence-based interventions initiated by health care providers who work with adults would be effective strategies.

LEARNING OBJECTIVES:
Describe the process for assessing coverage levels for adults aged 50 to 64 years in San Diego County.