Nature of the Problem: According to the 2003 California Health Interview Survey (CHIS), only 73.9% of all respondents who were 65 years or older reported they had received a flu shot in the past 12 months. Additional analysis of these responses revealed several differences among race/ethnic groups. Non-Latino Asians had the highest coverage at 78%, followed by Non-Latino Whites at 75%, Latinos at 72% and Non-Latino African Americans at only 59%. Pneumococcal immunization coverage in the 65+ population was 63%, with a slightly different breakdown by race/ethnicity: Non-Latino Whites at 68%, Latinos at 54%, Non-Latino African-Americans at 53% and Non-Latino Asians at 51%. These rates are disappointing when compared to the National Healthy People 2010 goals of 90% coverage for both flu and pneumococcal vaccination for individuals 65 years and older. The magnitude of this problem in the future will be compounded by the projected growth of this age group by 2010. According to the 2000 Census, more than 3.5 million people are age 65 or older, representing more than 10 percent of the California’s total population. In 2010, one in five Californians will be age 65 or older.

Health services research studies have consistently found that vaccinating adults (65 years and older) is strongly correlated with a significant reduction in the morbidity, mortality and related health care costs in this population. In June 1999, the CDC’s Task Force on Community Preventive Services released a report of evidence-based recommendations on the use of interventions to increase vaccine coverage levels in children, adolescents, and adults. Even though these recommendations have been widely published and distributed, they have not been fully implemented by health care providers and communities.

In the past few years, several complex issues have contributed significantly to the immunization rates of adults in California. Some of the issues identified by health care and public health professionals include:

California Adult Immunization Coalition (CAIC): The CAIC Steering Committee was established in June 2002 by over 20 organizations committed to developing a long-term, strategic, and integrated effort to improve adult immunization rates for adults, particularly those who are underserved, at risk and/or have limited access to preventive care services in California. All of the participating organizations were implementing strategies to improve adult immunization rates, either individually or with a limited number of partners, but fully recognize the potential benefits of collaborating with a broader group of leaders/organizations to improve adult immunization rates. As a result of a shared vision and commitment, the CAIC Steering Committee adopted the following mission statement:

 To build and support cross- sector (medicine, public health, community) collaboration that results in improved adult immunization rates, particularly the rates among high risk adults and of those adults who have limited access to preventive care.