Shot In The Dark - Missed Opportunities For Adult Vaccination Are Common
February 5, 2014

Thousands Of Unvaccinated Adults Die Needlessly Every Year

Lee Rannals for - Your Universe Online

According to a new study published in the Annals of Internal Medicine, thousands of unvaccinated adults die every year from preventable diseases.

Researchers from the University of Colorado School of Medicine were the first to study several important aspects of adult vaccination. Adults currently make up 95 percent of those who die annually from vaccine preventable diseases, which causes nearly 30,000 deaths each year.

"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 Laura Hurley, MD, MPH lead author of the study and an assistant professor of medicine at the CU School of Medicine. "Also, most physicians are not stocking all recommended vaccines."

Previous studies have shown that only about 65 percent of adults at 65 years of age and older received a pneumococcal or influenza vaccine. These statistics also revealed that only 20 percent of high risk adults between 19 and 64 years old received a pneumococcal vaccine, while only 16 percent of adults aged 60 and older received a shingles vaccination.

The Colorado researchers collaborated with the Centers for Disease Control and Prevention to design a survey for primary care physicians looking at how doctors assessed vaccination status and stock the recommended vaccines.

"Physicians reported a variety of barriers to vaccine stocking and administration but financial barriers dominated the list," the researchers wrote in the journal. "Physicians in smaller, private practice often assume more risks from stocking expensive vaccine inventories and may be particularly affected by these financial barriers."

Hurley said that many doctors taking part in the study said it was difficult to get reimbursed by insurance agencies for vaccines. For example, the recommended herpes zoster vaccine is not widely stocked by physicians because they said that although it is covered by Medicare Part D, they have trouble receiving reimbursement for it. This vaccine also has substantial out-of-pocket costs for patients, making it hard to push the vaccine on them.

"The most commonly reported reasons for referring patients elsewhere for vaccines included insurance not covering the vaccine," the study said.

Researchers also found problems with coordinating vaccine records when they had been performed by someone who is not the patient’s primary care physician. In order to combat this problem, the authors suggest using a confidential database known as Immunization Information Systems so it can allow doctors to know when vaccinations have been given

The team said the Affordable Care Act could help address some of these problems because it requires insurers to cover recommended vaccinations with no co-pays when delivered by in-network providers. However, Hurley says more action needs to be taken into this issue.

"I feel we need to take a more systematic approach to this issue," Hurley said in a statement. "As the population ages this could easily grow into a more serious public health issue."