•
•
•
•
Many healthcare professionals not staying current on vaccine recommendations. The complexity of vaccination recommendations and schedules for adults, including the guidance based on riskgroup categories. Financial impediments to vaccination, e.g., uncertainty as to whether insurance reimbursement will be forthcoming. Acute and chronic medical management taking precedence over preventive services.
How You Can Help Overcome Low Vaccination Rates Among Adults
The National Vaccine Advisory Committee (NVAC), an expert body that advises the Department of Health and Human Services, has developed national standards with the goal of improving adult vaccination coverage for all vaccines recommended by the Advisory Committee on Immunization Practices (ACIP). In 2014, NVAC published “Standards for Adult Immunization Practice.”7 These recommendations call on all healthcare providers — whether they provide vaccinations in their healthcare settings or not — to take steps to help ensure that their adult patients are fully immunized. The four “Practice Standards for All Healthcare Professionals” are: 1. ASSESS the vaccination status of your patients at every clinical encounter. For providers to do this, they and their clinic staff need to stay informed about the latest CDC vaccine recommendations for adults. 2. STRONGLY RECOMMEND needed vaccines for your patients. Clinicians are known to be the most valued and trusted source of health information for adults. Research shows that most adults believe vaccines are important and that a recommendation from their healthcare professional is a key predictor of whether patients get needed vaccines. 3. ADMINISTER recommended vaccines or REFER patients to a vaccination provider. Make vaccination MetroDoctors
services in your practice as convenient as possible for patients. If you do not stock certain vaccines or if you do not provide vaccines at all, refer your patients to a specific provider known to have the needed vaccines available. HealthMap Vaccine Finder is a free, online service where users can search for locations that offer immunizations. Enter your zip code at http:// vaccine.healthmap.org. 4. DOCUMENT the vaccines your patients receive, whether they are administered by you or elsewhere. Place that information in your state immunization registry, if you have one available, and Minnesota does. Also, be sure to give your patients a record of their vaccinations. This is particularly helpful when they see different providers for different health needs. If you send them to another provider, follow up with your patients to make sure they received the vaccines you recommended. Resources to assist providers with implementation of these standards for adult immunization practice are available at www.cdc.gov/vaccines/hcp/patient-ed/ adults/for-practice/standards/index.html. So—Which Vaccines Are Recommended for Adults, and on What Schedule?
Each February, the Centers for Disease Control and Prevention (CDC) releases its “Recommended Immunization Schedule for Adults Aged 19 Years or Older,”8 complete with tables and explanatory footnotes that describe the details of each recommended vaccine. The schedule is available online at www.cdc.gov/vaccines/schedules/ downloads/adult/adult-combined-schedule.pdf. These CDC recommendations are endorsed by the American Academy of Family Physicians, the American College of Physicians, the American College of Obstetricians and Gynecologists, and the American College of Nurse-Midwives. Need Help? The Immunization Action Coalition Can Assist!
The Immunization Action Coalition (IAC), a national nonprofit organization
The Journal of the Twin Cities Medical Society
based in St. Paul, Minnesota, is the nation’s leading immunization education organization. Its two main websites, www. immunize.org for healthcare professionals and www.vaccineinformation.org for the general public, average more than 30,000 visitors daily. Immunize.org, is the “goto” destination for busy practitioners who want up-to-date, ready-to-print CDCreviewed educational materials on U.S. vaccine recommendations and schedules, as well as guidance on vaccine administration, and much more. IAC has worked in close collaboration with CDC on vaccination education since the early 1990s and has been the recipient of continuous CDC funding for its work since 1995. Visit www.immunize.org/handouts to access more than 250 free ready-to-copy educational materials — all of which are carefully constructed to be clear, concise, accurate, and useful in medical practice settings. More than 3.5 million PDF copies of staff and patient educational materials were downloaded over the past 12 months. The website includes a wealth of adult immunization content. Your Patients are Counting on You
Adult patients rely on their healthcare providers to keep them informed about how to protect their health. This includes providing guidance on recommended vaccines. Based on the national statistics for adult vaccination coverage, it is likely that you have adult patients in your practice who are behind schedule on one or more recommended vaccines, such as Tdap, zoster, pneumococcal conjugate or polysaccharide vaccine, or HPV vaccine. You and your staff can help your patients determine which vaccines they need now and when the next ones are due. Even if you do not provide vaccination services in your practice, it is still important to obtain your patient’s vaccination history, determine which vaccines they need, and then direct them to another provider, such as a local pharmacy, that will administer needed immunization. (Continued on page 26) July/August 2016
25