Adult Vaccination Against Preventable Diseases Now Urgent, says NAIIS

August 25, 2021

Low rates of routine adult vaccination, reduced further during the 2020-21 pandemic months, threaten a surge in these conditions as the US reopens, says the National Adult and Influenza Immunization Summit.

Most adults in the US are missing one or more routine recommended vaccines. According to the most recent data published on all recommended vaccines from the 2018 national Health Interview Survey, at least 3 out of every 4 adults are missing 1 or more of 4 routinely recommended vaccine: influenza, pneumococcal, zoster, and tetanus toxoid-diphtheria or tetanus toxoid-diphtheria-pertussis.

There are also significant gaps in uptake of vaccines recommended for adults based on age, medical conditions, occupation, and other factors; a key example is the HPV vaccination - nearly half of women and 75% of men aged 19- to 26-years-old have not received the immunization.

Adult vaccination coverage also differs widely by race and ethnicity and the disparities have increased recently for several vaccines. The National Adult and Influenza Immunization Summit (NAIIS) notes that in 2019 29% of non-Hispanic White US adults aged 50 or older had received the zoster vaccine, only 18% of non-Hispanic Black and 15% of Hispanic adults had been vaccinated.

The COVID-19 pandemic further suppressed routine vaccinations as Americans avoided preventive care.

The NAIIS*, a group representing more than 130 public and private organizations, focuses on addressing issues related to adult vaccination of all types and improving use of Advisory Committee on Immunization Practices-recommended adult vaccines.

The NAIIS adds its voice to warnings that as people continue to move more freely in communities and between states and continents, the reduced rates of non-CVOID-19 infections the US saw last year (eg, such as influenza, pertussis, pneumococcal pneumonia, bacterial meningitis) are likely to reverse this year. They point to the already documented increase seen in respiratory syncytial virus.

They point to research that has found a health care providers' recommendation is a "key predictor of adults’ decisions to get vaccinated." it is unfortunate that surveys also have found that the majority of adults do not discuss vaccination with their clinicians.

The partner organizations of the NAIIS call on all clinicians and other healthcare providers, such as pharmacists, occupational health, and clinical subspecialists, to follow the National Vaccine Advisory Committee (NVAC) Standards for Adult Immunization Practice including:

Assess the vaccination status of patients at each clinical encounter, including assessment by clinicians and other providers who do not stock vaccines..
- Use the jurisdiction’s immunization information system (IIS) to view patients’ prior vaccinations to support vaccine needs assessment
Identify the vaccines each patient needs, then clearly recommend those needed vaccines.
Offer needed vaccines or refer patients to another provider for vaccination.
Document vaccinations given, including in the jurisdiction’s IIS.
- Many electronic health record (EHR) systems already link to the jurisdiction’s IIS; providers should check with their EHR administrators if uncertain..
- Providers not already utilizing an IIS should contact their local or state immunization programs to inquire about enrolling in their jurisdiction’s IIS
Measure vaccination rates of each provider’s patient panels; make changes to clinic patient flow and take other steps to address barriers to patient vaccination.