Docs see missed opportunities for adult, kid vaccinations

American immunization rates could get a boost from practices like vaccinating people during unrelated medical visits and creating standing orders for vaccinations that personnel other than physicians can administer, according to new recommendations for childhood and adult vaccination.

"Part of the problem lies with healthcare providers … who miss opportunities, such as sick visits, emergency room visits or visits during which a sibling or parent is being seen, to administer needed vaccines," say Yemisi Adetunji, M.D., M.P.H., of the University of North Carolina at Chapel Hill and colleagues.

Systems that remind physicians and patients when immunizations are due, regular monitoring of immunization rates at specific clinics and financial aid for those who can not afford vaccination costs are among other suggested strategies for improving immunization coverage.

These recommendations are included in updated childhood and adult immunization standards in the July issue of the American Journal of Preventive Medicine.

Ninety percent of adults age 65 and older should receive an annual flu vaccine and at least one dose of pneumococcal vaccine, according to goals set by the National Vaccine Advisory Committee. In 2000, only half of these adults had received a pneumococcal vaccine, while 66 percent received an annual flu shot.

As part of the revised standards, the committee will release a set of intervention tools on CD-ROM and online to help physicians raise immunization rates, including information on setting up standing orders and instructions for reminder systems.

The recommendations for childhood immunizations endorse similar interventions, and encourage physicians to report adverse vaccine reactions to a national database so that vaccine safety may be improved.

The revised standards should help reduce deaths and disability across the lifespan, say researchers.

For instance, the Centers for Disease Control and Prevention estimate 900 deaths and 1,300 hospitalizations could be avoided each year by vaccinating an additional one million elderly people for flu.

And previous research suggests that each dollar spent on childhood immunization could save $10 to $14 in future disease costs, according to Adetunji and colleagues.

By Becky Ham, Staff Writer
HEALTH BEHAVIOR NEWS SERVICE

FOR MORE INFORMATION
Health Behavior News Service: (202) 387-2829 or www.hbns.org.
Interviews: Contact Yemisi Adetunji at (908) 806 4447 or Yadetunji@aol.com.
American Journal of Preventive Medicine: Contact the editorial office at (619) 594-7344.

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