Start Getting Your September Shots! Raising Awareness About Adult Vaccinations

Because October officially marks the beginning of flu season, the month of September is a critical time for all to get immunized against pneumonia and flu. This is an opportunity to bring attention to the need for persons of all ages, but especially older adults, to get these necessary vaccines.

Immunizations are a critical step toward prevention of certain diseases. Two of those vaccine-preventable diseases are pneumonia and influenza, which result in more than 600,000 annual hospitalizations with direct costs of more than $7 billion per year just for the older adult population.

On the more dire side, it is estimated that 90 percent of all pneumococcal disease cases occur in adults and, as I said in testimony I delivered to an advisory committee of the Centers for Disease Control and Prevention (CDC), "We know from reports that pneumococcal illnesses kill one in every four to five persons over 65 who contract them and this represents 90 percent of deaths that occur from complications of pneumonia and influenza."

We need to focus more attention on and provide more education about vaccines as we continue to have disturbingly low rates of vaccinations among those adults who need them the most. In 2012, the CDC indicated that only 20 percent of younger adults at high risk for pneumonia had even received a pneumococcal vaccine and only 59.7 percent of older adults had received one.

Adult immunization rates are generally affected by three key categories. The first is that immunizations may not be viewed as a priority health concern by patients and/or providers, with other preventive care practices being given priority over immunizations. Health systems and processes can make routine immunizations harder than necessary, with an absence of standing orders to make vaccine administration more routine. Finally, inconsistent and uncoordinated policies may discourage immunizations with factors including variable insurance coverage for immunizations across health plans.

For older adults on Medicare, in the past two years, the Centers for Medicare and Medicaid Services (CMS) approved the more advanced PCV13 pneumococcal vaccine for coverage for all beneficiaries and made it retroactive for coverage to September 2014. This allows all older Medicare beneficiaries the opportunity to get this improved vaccine which had previously been available generally only for newer Medicare beneficiaries.

However, it is distressing to note that CMS plans no beneficiary or provider outreach during this pneumonia and flu season to advise that this important new vaccine is now covered. Advocates are hoping to convince CMS to change their position and offer important education and outreach. We also need to encourage more adults reaching age 65 to get their free Welcome to Medicare visit where they can learn more about the importance of immunizations.

Surveys indicate that if physicians and health care providers recommend immunizations, it will positively impact patient behavior. Yet we have studies which point to 70 percent of physicians' reported lack of awareness about something as basic as pneumococcal vaccination schedules.

In essence, from the federal government to the public at large to the provider community, we must ramp up our awareness-raising about the importance of vaccines to older adults. It is especially important that the national aging network, which comes into contact with older adults on a daily basis, do all it can to help in this educational effort. One association, the National Association of Nutrition and Aging Services Programs (NANASP), provided placemats with information on vaccines at nutrition programs to both congregate meal participants and home delivered meal recipients.

In addition, it is especially important to do focused and targeted outreach to two other important communities. The first is the caregiver community. Caregivers have a dual mission to ensure that the person they care for is properly immunized in a timely fashion and to also ensure that they are as well to avoid spreading disease to their loved one. This is especially true of the rising number of grandparents raising grandchildren in this nation.

The second are minority communities including and especially native Americans. Racial and ethnic groups are at increased risk, but outreach efforts are often more challenging. It is especially important for health care providers serving minority racial and ethnic groups be proactive in urging immunizations as CDC statistics show that 40 percent more African Americans and 36.2 percent of Hispanics are willing to get vaccinated if vaccines are recommended by their health care provider.

As we approach the final stretch of the election season in America, let us accompany all campaigns to get out the vote with a message to get vaccinated as well. And, as we approach the college and professional football seasons and the playoffs in Major League Baseball, let us urge these leagues to allow public service advertising on the need for vaccinations.

We grew up with the motto that an ounce of prevention is worth a pound of cure; let's apply this to our approach with vaccinations.