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Vaccines Aren’t Just For Kids: Health Plans Aim To Reduce Vaccine Disparities

posted by Chris Regal, AHIP Senior Health Research Associate

on April 23, 2018

Vaccination rates vary among different racial, ethnic, and age groups.

A Google search of “disparities in vaccinations” produces numerous references to childhood immunizations.

While disparities exist in childhood immunizations, adults need vaccines too. And the immunization disparities among adults are a major problem. In fact, a CDC report indicates the prevalence of vaccine-preventable illnesses is greater among adults than children.

Why the disparities? Cultural differences could lead to misunderstandings around vaccines and the social determinants of health can contribute to lower adult vaccination rates. Some adults never received their shots during childhood, some didn’t complete a full series of shots, and others may not know there are immunizations that need “booster” doses to refresh and maintain protection.

Certain vaccines are appropriate only for adults and should not be ignored. The adult immunization recommendations include:

  • Adults should receive the annual flu vaccine.
  • Adults over age 65 should receive the pneumococcal vaccine, which protects against infections in the lungs and bloodstream.
  • Any adult who did not receive the Tdap vaccine as a child should get the vaccine to prevent pertussis (whooping cough) and a Td (tetanus, diphtheria) booster shot every 10 years.
  • Adults over 60 should receive the herpes zoster vaccine to prevent shingles.

Unfortunately, accompanying the need for immunizations are disparities among race and ethnic groups that put minority populations at risk.

  • About 48.5 percent of white individuals over the age of 19 received the flu vaccine, compared with 38 percent of black and 33 percent of Hispanic or Latino individuals.
  • Over age 65, 68 percent of white individuals have been given the pneumococcal vaccine, compared to 50 percent of blacks and 42 percent of Hispanics.
  • For people over the age of 60, 35 percent of whites receive the herpes zoster vaccine, compared to 14 percent and 16 percent of black and Hispanic people, respectively.

To address these disparities and improve vaccination rates in general, AHIP and health insurance providers collaborated on best practices and shared strategies, which are included in the report “Improving Adult Immunization Rates.” The report outlined specific actions for health plans, including:

  • Work with physician practices to ensure that prevention and wellness and age-appropriate vaccines are given equal attention—similar to chronic and acute care needs—including offering vaccines during an office visit
  • Continued emphasis on promoting and tracking preventive services including vaccines for adults, consistent with Advisory Committee on Immunization Practices (ACIP) recommendations
  • Continued implementation of value-based incentives that reward preventive care, including adult vaccines
  • Assess adult vaccination status during transitions of care for adults to address gaps and disparities within adult immunization
  • Raise awareness among adult members about the vaccines they should receive and the available options to access them
  • Provide support to help ensure that providers have adequate resources to administer vaccines for adults

Immunization disparities still exist, but the good news is that vaccine rates for all groups are on the rise. And we can continue to improve vaccine rates for all populations—by raising awareness and addressing how sociodemographics and social determinants of health affect an individual’s decision to get vaccinated.