One of the most important public health achievements of the 20th and 21st centuries is vaccinations. Vaccines help save lives and increase quality of life standards by preventing infectious diseases and their consequences. Still, too many people don’t realize how important vaccines are. Despite the widespread availability of safe and effective vaccines, the vaccination rates among adults in the United States remain far below targets.
Preventable diseases take a heavy toll on adults, with influenza leading the way. The Center for Disease Control and Prevention (CDC) estimates that, each year, there are 40,000 cases of pneumococcal disease, which encompasses pneumonia and meningitis. 4,000 deaths result from this disease yearly. The CDC also attributes between 3,000 to 49,000 deaths each year to seasonal influenza among adults. Additionally, outbreaks of measles and many other easily preventable diseases can affect adults. Unvaccinated adults can unknowingly spread those diseases to children who are too young to get the vaccine themselves.
As the U.S. population continues to age, the public health impact of these preventable diseases is likely to grow. As humans age, the immune system lessens its response to vaccination—this fact reinforces the need to create and develop more vaccines for older adults. Understanding the National Adult Immunization Plan (NAIP)will help the populace understand the importance of vaccination, how vaccines work, and where to get them.
Adult Immunization Obstacles
Many barriers must be removed before any significant progress can be made in adult vaccination. Many stakeholder groups and researchers have identified several barriers that have allowed the goals of the adult vaccination plan to remain unmet. Groups within the medical community have voiced their concerns on what they see as the biggest challenges facing the initiative. These challenges include but aren’t limited to:
- Lack of integration of vaccines into adult care
- The population’s skepticism of vaccine safety and effectiveness
- Provider concerns about reimbursement by health care insurers
- Conflicting and inaccurate information about vaccines in the media
- Patients’ inability to pay for vaccines due to lack of insurance or health coverage
- Legal barriers at the state or local level over who can administer vaccines
In an attempt to remove these barriers, the NAIP is broken down into a four-step plan. The purpose of the plan is to coordinate action across all stakeholder groups, including those outside the U.S. government, to get more adults to commit to understanding and getting vaccinations. The plan itself states, “The vision for adult immunization is to protect the public health and achieve optimal prevention of infectious diseases and their consequences through vaccination of all adults.”
Goal 1: Strengthen the adult immunization infrastructure
The first goal is broken down into six objectives that, once implemented, will strengthen and support the infrastructure of adult immunization. Vaccines have always worked in adults; they have a long track record of safety and effectiveness. But when vaccines are introduced on a larger scale, their effectiveness can be diminished. Translating policy into positive outcomes depends on hard data and surveillance. The data determines whether the information being provided to the public is having a positive effect on immunization rates—in other words, whether the plan is working.
The surveillance must go down to the basic level of storage and handling to ensure the vaccines are properly stored in pharmaceutical freezers and administered in a timely and safe manner. Vaccine safety isn’t only the manufacturers’ responsibility— many other entities, such as pharmacies, doctor’s offices, and any other establishments that might give the vaccine to the general public, are also responsible.
Goal 2: Improve access to adult vaccines
The main objective of this step is to remove all barriers for adults so that they can get the vaccines they need. An available supply of vaccines isn’t the problem causing low vaccination rates among adults. Pharmaceutical companies can make enough vaccines for every man, woman, and child in America to have two of each type. Rather, many caregivers and medical professionals cite their patients’ inability to pay for vaccines as the major barrier standing in the way. Many programs offer free vaccines to eligible children, but no such program exists for adults. The Affordable Care Act has eliminated some financial barriers to vaccinations for many Americans, but a significant segment of the population still can’t get access: the uninsured. They must continue to pay out-of-pocket. The NAIP will work to expand the provider network for adult immunizations and make sure there’s a robust inventory of vaccines during public health emergencies.
Goal 3: Increase community demand for adult immunizations
The purpose of this goal is to address the needs of adults and providers of adult vaccination services. Because adults make medical decisions for their kids, educating adults about the importance of vaccines will help ensure they get their own vaccinations, too. Communication and community outreach are the important keys to this goal. It’s important to address any and all misconceptions and skepticism toward adult vaccinations. Continued outreach will lessen the misgivings toward vaccines and reinforce the importance of getting them throughout a lifetime.
Education alone isn’t enough to change minds, but it’s an important step in the process. It has the most impact when combined with fact-based initiatives. Adults tend to think that once they pass a certain age, their risk of contracting a disease lessens. This misguided belief is what leads to lower vaccination rates in adults and increases cases of preventable diseases.
Goal 4: Foster innovation in adult vaccine development and vaccination-related technologies
The final goal is the further development and innovation of adult vaccines. Most existing vaccines are highly effective in children, but they are less effective in adults, especially in older adults with weakened immune systems and existing diseases. The perception that vaccines aren’t effective in older adults leads to a reduction in demand for the vaccines and a lower rate of vaccination among adults. The changing demographic and the aging of such a large population highlights the need for a better understanding of how vaccines work in older adults and how better vaccines can be made. Development of next-generation vaccines must begin in order to protect against serious diseases that are prevalent in this population.