Vaccination is at the forefront of regular preventative healthcare practices for children, supported by federally funded programs like Vaccines for Children (VFC), and widely promoted, discussed, and supported by healthcare professionals.
Per the CDC, the percent of children aged 19-35 months receiving vaccinations for:
- Diphtheria, Tetanus, Pertussis (4+ doses DTP, DT, or DTaP): 84.6%
- Polio (3+ doses): 93.7%
- Measles, Mumps, Rubella (MMR) (1+ doses): 91.9%
- Haemophilus influenzae type b (Hib) (primary series + booster dose): 82.7%
- Hepatitis B (Hep B) (3+ doses): 92.6%
- Chickenpox (Varicella) (1+ doses): 91.8%
- Pneumococcal conjugate vaccine (PCV) (4+ doses): 84.1%
- Combined 7-vaccine series: 72.2%
Conversely, adult vaccination rates are significantly lower. Per the CDC, the estimated percentage of adults ≥19 years who received the following vaccinations:
- Pneumococcal vaccination: 23.0%
- Tetanus vaccination (received in past 10 years): 61.6%
- Tetanus vaccination including pertussis vaccine (received in past 10 years): 23.1%
- Hepatitis A vaccination (at least 2 doses), ever: 9.0%
- Hepatitis B vaccination (at least 3 doses), ever: 24.6%
- Herpes zoster (shingles) vaccination, ever: 30.6%
Per the CDC, the estimated proportion of adults 19-26 years who received the following vaccinations:
- HPV vaccination among females (at least 1 dose), ever: 41.6%
- HPV vaccination among males (at least 1 dose), ever: 10.1%
Unlike children, who are typically subject to school admittance requirements for vaccination, there are no requirements for adults to stay current on their immunizations. However, immunity from childhood vaccines can wear off over time, and adults are at risk for different diseases.
Long-term illness, hospitalization, even deaths are caused every year by vaccine-preventable disease. In the US alone:
- The CDC estimates that since 2010, as many as 710,000 flu-related hospitalizations and up to 56,000 flu-related deaths have occurred.
- Nearly 900,000 people get pneumococcal pneumonia every year, resulting in up to 400,000 hospitalizations and 19,000 deaths.
- Up to 1.4 million people suffer from chronic hepatitis B, which can also cause complications such as liver cancer.
- HPV causes over 27,000 cancers in men and women annually, and about 4,000 women die each year from cervical cancer
- 1 million people get shingles every year, some will have further painful complications even after the rash has cleared
Vaccines remain one of the safest preventative care measures available, and are important in reducing the spread of preventable diseases to the elderly and children. The CDC recommends that every adult get influenza (flu) and Td (Tdap) vaccines every year.
In order to increase the level of adult vaccination, the CDC has recommended better vaccination programs, increased access to vaccination services, and the removal of any barriers to vaccine coverage. Per the National Center for Biotechnology Information (NCBI), these barriers include:
- Lack of recognition of the importance of adult immunization,
- Lack of recommendation from health care providers,
- Lack of health care provider knowledge about adult immunization and recommended vaccines,
- Misrepresentation/misunderstanding of the risks of vaccine and benefits of disease prevention in adults,
- Lack of understanding of vaccine safety and efficacy,
- Missed opportunities for vaccination in health care providers’ offices, hospitals, and nursing homes,
- Lack of publicly-funded vaccine and reimbursement to vaccine providers,
- Lack of coordinated immunization programs for adults,
- Lack of regulatory or legal requirements,
- Fear of injections, and
- Lack of availability of up-to-date records and recording systems.
To combat these challenges, there are resources available to guide physicians and their teams through creating a team-based approach for adult vaccination programs. The American Medical Association (AMA) has created a free online module called AMA STEPS Forward™. There are six recommended steps:
- Get the health team on board with conveying a strong support for adult vaccination.
- Team training on vaccine fundamentals, communicating benefits and risks of vaccines, preparation, administration, and adverse event reporting.
- Prepare to address common patient questions, and educate against misinformation found in the news, online, etc.
- Implement a standardized process and protocols.
- Document vaccines given and reduce financial risk by educating the team on safe vaccine storage and handling to avoid common mistakes like improper vaccine refrigerator temperatures.
- Reward and recognize team participation.
Of these six steps, one important factor is the oversight and handling of vaccine storage. The risk of not using purpose-built refrigerators and freezers for vaccine storage can result in reputational and financial losses.
Recently, a Veteran’s Affairs (VA) hospital in California was reported to have administered a compromised flu vaccine to as many as 1,800 patients due to a faulty refrigerator.
The article can be found here.
As the VA San Diego Healthcare Director Dr. Robert Smith states, “There isn’t any risk from this vaccine. It’s not that’s contaminated [sic]. It’s not that it has side effects, but we can’t be sure it’s effective. In fact, it might be effective, but we can’t be certain,” thus necessitating the need for patients to return and get another dose. It’s unknown how many patients have returned for a second vaccination, compounding the challenge of administering adult immunizations.
Proper vaccine storage and monitoring is essential to guarding against wasted vaccines, and against the financial losses and reputational risks that accompany needing to re-administer vaccinations. Working to increase the levels of adult vaccination presents challenges aplenty, keeping vaccines stored safely and effectively is a simple contribution towards the cause.
K2 laboratory refrigerators and freezers are compliant with CDC guidelines for safe vaccine storage, and include audible and visual temperature alarms (so you can hear if the temperature goes out of range on a unit), door locks, magnetically sealed doors, and rapid cool-down mode after door opening. They include access ports for the installation of a Digital Data Logger (DDL) and remote alarm contacts.