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 Certain groups of adults are at increased risk of infection or complications from vaccine preventable disease due to working conditions, behavioral and/or health issues. Risk factors for specific diseases can vary, and common risk factors include age and chronic illnesses.1 For pneumococcal disease, the case fatality rate among younger adults (aged 18 to 64) with risk conditions has been estimated to be more than twice that of younger adults with no risk conditions.1

Vaccination rates for high-risk adults, like the general adult population, remain lower than recommended levels. Pneumococcal vaccination among adults aged 19–64 years at high risk was 20.3% in 2014.2 Healthy People 2020 targets pneumococcal vaccination for high risk adults at 60%.3 Healthy People 2020 also targets hepatitis B vaccination in health care workers, a high risk group, at 90%, but the coverage rate was only 64% in 2008.3 Healthy People 2020 objectives also include increasing influenza vaccination for all persons to 70%, yet only 47.6% of 18-64 year olds were vaccinated against influenza in the 2014-15 season.3-4



NEVADA: Outreach to Vulnerable Seniors

The Nevada State Immunization Program provides 317-funded vaccines to a local health district (LHD) for community outreach to vulnerable seniors.



WASHINGTON: Community and migrant health center quality improvement initiative

The Washington State Office of Immunization and Child Profile (OICP) worked with community and migrant health centers to conduct quality improvement activities aimed at increasing adult immunization rates.


  NEW YORK CITY: Hepatitis B prevention for high-risk adults

The New York City (NYC) Department of Health and Mental Hygiene (DOHMH) Bureau of Immunization (BOI) conducted a multi-faceted project to support hepatitis B vaccination of high-risk adults.
1 “Task Force on Community Preventive Services.” Recommendations to Improve Targeted Vaccination Coverage Among High-Risk Adults. Am J Prev Med 28.5S (2005): 231-237. Print.
2 Williams WW, Lu P, O’Halloran A, et al. “Surveillance of Vaccination Coverage Among Adult Populations — United States, 2014.” Morbidity and Mortality Weekly Report Surveill Summ 65. SS-1 (2016): 1–36. Print.
3 “Immunization and Infectious Disease Objectives.” Healthy People 2020. US Department of Health and Human Services, 2014. Web.
4 “2010-11 through 2014-15 State, Regional, and National Vaccination Trend Report.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 2015. Web.
5 2015 AIM Annual Survey, 63 of 64 state/city/territorial Immunization Programs completed the survey that was administered online April - June 2015.

Chapter 8 Resources

Item Name Posted By Date Posted
AIM Survey Data: Using Media to Target High Risk PDF (150.04 KB) Administration 12/19/2016
CMS QIN-QIO General Information  Link Administration 4/5/2017
IZ Initiative-CMS Quality Innovation Network Link  more ] Administration 12/19/2016
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