Unlike children, who have regularly scheduled vaccines as part of their well-checks, older adults are on their own when it comes to knowing what vaccinations would be good for their health. While the 2009 novel H1N1 flu outbreak brought tremendous awareness to vaccines, it also was a “serious reminder that there is no strong mechanism in place for vaccinating adults in the United States,” according to a new report that examines these low rates in adults.

The 28-page report, Adult Immunization: Shots to Save Lives, says that millions of Americans go without routine vaccinations for preventable diseases, resulting in as many as 50,000 adult deaths every year. The report cites the 2007 National Immunization Survey by the U.S. Centers for Disease Control and Prevention (CDC), which highlighted the problem of low adult vaccination rates. Here are some of the findings:

• Just under 70% of seniors had the pneumococcal vaccine (the CDC’s 2010 goal is a 90% vaccination rate). Oregon had the highest immunization rate for pneumonia among seniors at 73.2%; Washington, D.C., had the lowest, 55.4%.
• Sixty-nine percent of adults 65 and over were vaccinated for seasonal flu (which can lead to pneumonia in the elderly).
• Fewer than 2% of adults 60 and older got the vaccine for shingles, an extremely painful condition that one of three adults will get in their lifetime.
• Only 2.1% of eligible adults 18 to 64 had received vaccines for tetanus, whooping cough, and diphtheria.

Failure to use the vaccines adds about $10 billion annually to the cost of heath care, according to the CDC.

Adults often don’t have regular checkups, and they “switch doctors and health plans often, which makes it extremely difficult to set up ways for people to know what vaccines they need and for doctors to track and recommend vaccines to patients,” the report noted. In addition, private medical insurance does not always pay for adult vaccines, some of which are expensive, and even governmental program support is “inconsistent.” And unlike children and teenagers, many adults are not connected to an institution that would require vaccinations. Finally, misinformation about a vaccine’s effectiveness and safety is another obstacle for adults.

The report, which can be read at this link, was prepared by the Trust for America's Health, a nonpartisan health research group; the Infectious Diseases Society of America; and the Robert Wood Johnson Foundation, the largest health care philanthropy in the country.