Too few adult Americans get the vaccinations they need to protect their health and maybe even their lives, federal health officials say.

"Despite the continuing occurrence of vaccine-preventable diseases among adults in the United States, safe and effective vaccines recommended for adults are not optimally used," the Centers for Disease Control says in its Morbidity and Mortality Weekly Report.For example, the CDC said:

- While influenza vaccine is about 75 percent effective in reducing deaths in older people at high risk of the disease, a 1987 survey found only 32 percent of adults over age 65 had received flu shots.

- Large measles outbreaks occurred on college campuses in five states in 1989; only one state required students to be immunized before they enrolled.

- Between 6,000 and 8,000 health-care workers are infected each year with the hepatitis B virus. Yet in 1988, just 19 percent of U.S. and Canadian medical schools required their students to get hepatitis B vaccinations.

- Pneumococcal vaccine is more than 60 percent effective in preventing invasive pneumococcal infections, which cause as much as one-fourth of all pneumonia cases and 40,000 deaths a year. A 1985 study concluded that only 10 percent of people at high risk received the shots.

Between 1985 and 1989, adults made up 92 percent of the nation's tetanus patients, 87 percent of hepatitis B patients and 45 percent of cases of rubella, also known as German measles. All those diseases are prevented by vaccine, the CDC said.

The National Coalition for Adult Immunization, which includes the American Medical Association, the American Lung Association, the CDC, other medical groups and drug companies, has set standards for adult immunizations. It recommends health providers routinely make sure their adult patients are getting the shots they may need.

If the standards are implemented, it "could markedly improve delivery of vaccines to adults" by the year 2000, the CDC said.

Meanwhile, the CDC said that starting Nov. 1, physicians have a new way to report adverse side effects of vaccines. The new system at the Department of Health and Human Services replaces those at the CDC and the Food and Drug Administration.