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Influencing Vaccine Uptake

How Can Physicians Influence Vaccine Uptake?

 Percentage of Population Vaccinated
 Percentage of Population Vaccinated 

According to Terri Rebmann, Ph.D., RN, CIC, FAPIC, Professor, Epidemiology and Biostatistics, College for Public Health and Social Justice, and Director, Institute for Biosecurity at Saint Louis University College for Public Health and Social Justice, healthcare providers at many points along the lifecycle continuum are uniquely positioned to positively impact vaccine uptake.

Centers for Disease Control and Prevention (CDC) research shows that many adults are not aware of all the vaccines they need. As a result, U.S. vaccination rates for adults are extremely low. For example, in 2016 only:

  • 26.6% of adults 19 years or older have received Tdap vaccination.
  • 24.0% of high-risk adults 19 to 64-years-old received the pneumococcal vaccination.
  • 43.5% of adults 18 years or older received the flu vaccination during the 2015-16 flu season.

OB/GYNs and Vaccine Uptake

Pregnant women and their babies are at an increased risk for influenza-related complications, including premature labor and preterm birth. Pertussis outbreaks also continue to occur with infants at highest risk of hospitalization and death, and a high number of OB/GYNs recommended parents receive the pertussis vaccine.

However, low immunization rates persist among pregnant women in the U.S. During the 2017-18 influenza season:

  • 49.1% of pregnant women received influenza vaccination before or during pregnancy.
  • 54.4% of women with a live birth received Tdap during pregnancy.
  • 32.8% received both recommended vaccines.

How Geriatricians and Primary Care Providers Can Help

The CDC identifies adults over age 65 as higher-risk for vaccine preventable diseases and recommends vaccines for influenza, tetanus, pneumonia, and shingles. Each year, about 18,000 adults 65 years or older die and 400,000 end up in the hospital because of pneumonia caused by pneumococcal bacteria. Another 1 million Americans get shingles, which can cause severe post-herpetic neuralgia or other painful complications for years afterwards. Yet, vaccine coverage among adults age 65 and older remained low in 2016:

  • 33% did not report pneumococcal or Td vaccination.
  • 80% did not report Tdap vaccination.
  • 66% did not report a shingles vaccination.

How Oncologists Can Drive Vaccinations Forward

The vaccine conversation is critical for oncologists because “individuals who are immunocompromised, such as those receiving chemotherapy for cancer are at higher risk of getting influenza and other vaccine preventable diseases,” according to Dr. Rebmann. So if oncology patients can be vaccinated, they should be. Family and household members should also be vaccinated to protect the immunocompromised individual.

Have the Talk

Dr. Rebmann believes that if primary care providers would start looking more holistically at all individuals’ risk for influenza and asking about occupational exposure or risk, it would add to the overall vaccine conversation, and more individuals within a family may become vaccinated.

“Primary care providers should ask about occupational risk. For instance, if the patient is a child care employee or they work in any healthcare setting, including long term care facilities, they work with a really vulnerable population—children, the immunocompromised, and the elderly. Vaccinating these individuals can reduce their risk of illness as well as protecting their vulnerable patients or clients,” she explained.

Most adults believe vaccines are important and research has found that individuals are much more likely to receive them if recommended by their healthcare professionals. This high level of patient trust places physicians and other medical professionals firmly at the forefront in the fight against vaccine-preventable diseases.

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