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February 19, 2014
Low Adult Vaccination Rates Are Serious Public Health Problem
Denver—In a growing public health problem, almost all of the 30,000 Americans who die of vaccine-preventable illnesses each year, 95%, are adults, according to a new study. The article, published recently in the Annals of Internal Medicine, notes that just 62% of adults 65 and older received a pneumococcal vaccine, while 65% were vaccinated against the flu. Only 16% of those 60 and older received a herpes zoster vaccination, meanwhile. For high-risk adults between ages 19 and 64, just 20% received a pneumococcal vaccine. “Our study suggests that missed opportunities for adult vaccination are common because vaccination status is not being assessed at every (physician's) visit, which is admittedly an ambitious goal,” said lead author Laura Hurley, MD, MPH, of the University of Colorado. “Also, most physicians are not stocking all recommended vaccines.” Instead, the study—based on a national survey of primary care physicians on how they dealt with vaccines in 2012—pointed out that physicians tended to refer patients to pharmacies or public health facilities for 11 recommended vaccines instead of stocking the products themselves. One reason was difficulties in getting paid, the authors explain. For example, the study points out that Medicare Part D, a pharmaceutical benefit, covers zoster and physicians report problems with reimbursement. In a recent report in the Morbidity and Mortality Weekly Report (MMWR), researchers from the CDC also lamented the low rate of vaccinations in adults. The article looked at vaccination rates for pneumococcal, tetanus toxoid–containing (tetanus and diphtheria vaccine [Td] or tetanus and diphtheria with acellular pertussis vaccine [Tdap]), hepatitis A, hepatitis B, herpes zoster (shingles), and human papillomavirus (HPV). Noting that most “vaccinations recommended for adults target different populations based on age, health conditions, behavioral risk factors (e.g., injection drug use), occupation, travel, and other indications,” the CDC reports that, compared to 2011, “only modest increases occurred in Tdap vaccination among adults aged 19–64 years, herpes zoster vaccination among adults aged ≥60 years, and HPV vaccination among women aged 19–26 years; coverage among adults in the United States for the other vaccines did not improve.” Researchers point out that racial/ethnic gaps in coverage continued for all six vaccines and actually widened for Tdap, herpes zoster, and HPV vaccination. Improvement in adult vaccination not only reduces the health consequences of preventable diseases among adults; it also can prevent pertussis morbidity and mortality in infants, they add. The MMWR article said successful vaccination coverage programs include the following elements: • Education of potential vaccine recipients and publicity to promote vaccination; • Increased access to vaccination services in medical settings; • Use of practices shown to improve vaccination coverage, including reminder-recall systems, efforts to remove administrative and financial barriers to vaccination, use of standing order programs for vaccination, and assessment of practice-level vaccination rates with feedback to staff members; and • More healthcare provider recommendations for vaccination. “In 2011, adult vaccination coverage in the United States for diseases other than influenza was similar to 2011, except for modest increases in Tdap vaccination for adults aged 19–64 years, herpes zoster vaccination among older adults, and HPV vaccination among women aged 19–26 years, with no improvements in coverage for the other vaccines recommended for adults,” the CDC researchers write, adding, “These data indicate little progress was made in improving adult coverage in the past year and highlight the need for continuing efforts to increase adult vaccination coverage.” |
U.S. Pharmacist Social Connect
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