Skip Navigation U.S. Department of Health and Human Services
Agency for Healthcare Research Quality
Archive print banner

Primary Care

This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: Let us know the nature of the problem, the Web address of what you want, and your contact information.

Please go to for current information.

Many elderly people believe they are unlikely to get the flu and don't realize they need the pneumonia vaccine

Influenza and pneumonia together are the fifth leading cause of death among the U.S. elderly. Even with appropriate treatment, 30 to 40 percent of deaths among the elderly are due to pneumonia. Yet in 1999, only 67 percent of older people received flu shots, and only 54 percent received the one-time pneumococcal vaccine. Rates were even lower for older blacks and Hispanics. Most unvaccinated elderly adults don't know that they need the pneumonia vaccine and feel that they are not at risk for getting the flu, according to a study supported by the Agency for Healthcare Research and Quality (HS09874).

Educational campaigns to increase vaccination rates among the elderly should emphasize the risk and severity of these diseases for older people, vaccine safety, and the existence of a pneumococcal vaccine, suggests Richard K. Zimmerman, M.D., M.P.H., and Tammy A. Santibanez, Ph.D., of the University of Pittsburgh. In 2000, Drs. Zimmerman, Santibanez, and colleagues surveyed a broad spectrum of elderly patients at urban, rural, and suburban sites about their vaccination status and beliefs about vaccination.

Overall, 1,007 people were surveyed. Those who received flu shots were much more likely than those who did not to know the symptoms of the flu. Similarly, 41 percent of elderly people who had been vaccinated against pneumonia could describe at least one classic symptom of the disease, compared with 35 percent of those who had not been vaccinated. Those who thought they could do something to keep from contracting pneumonia were more likely to have been vaccinated against it than those who thought they could not prevent it (77 vs. 54 percent). Of those who did not get flu shots, 19 percent felt they were not likely to contract the flu, 14 percent thought it would cause influenza, and 13 percent had a prior adverse reaction to the flu shot. About 34 percent of those who had never received the pneumonia vaccine did not know they needed it, 22 percent believed they were not likely to contract pneumonia, and 18 percent said that their doctor had not recommended it.

See "Knowledge and beliefs about influenza, pneumococcal disease, and immunizations among older people," by Dr. Santibanez, M. Patricia Nowalk, Ph.D., Dr. Zimmerman, and others, in the October 2002 Journal of the American Geriatrics Society 50, pp. 1711-1716.

Return to Contents
Proceed to Next Article

The information on this page is archived and provided for reference purposes only.


AHRQ Advancing Excellence in Health Care