U.S. Unveils comprehensive new adult vaccination plan

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http://www.examiner.com/article/u-s-unveils-comprehensive-new-adult-vaccination-plan

While childhood vaccination rates are well over 90%, adults are far more likely to be behind on vaccinations
http://www.hhs.gov/nvpo/national_adult_immunization_plan_final.pdf

Think you're up to date on your vaccinations? You might be surprised at how many vaccinations are now recommended for American adults -- and the federal government plans to start tracking which of those vaccines you're behind on.

The Department of Health and Human Services released its preliminary draft of a new five year plan to increase adult vaccinations this month. The newly revised 52-page National Adult Immunization Plan says:

    While the NVP provides a vision for improving protection from vaccine-preventable diseases across the lifespan, vaccination coverage levels among adults are not on track to meet Healthy People 2020 targets.

It describes the plan for the next five years as:

    Goal 1: Strengthen the adult immunization infrastructure.
    Goal 2: Improve access to adult vaccines.
    Goal 3: Increase community demand for adult immunizations.
    Goal 4: Foster innovation in adult vaccine development and vaccination-related technologies.

The plan further states:

    The CDC and its Advisory Committee on Immunization Practices (ACIP) currently recommends 13 different vaccines for adults age 18 and older to prevent a host of diseases.

These include vaccines they recommend for every adult (such as annual flu vaccines), vaccines recommended for every adult in certain age ranges (such as the HPV vaccine for men and women under 27, zoster for everyone over 60, and both PPSV23 and PCV13 for everybody over 65), and vaccines recommended for individuals with certain risk factors (such as the Hepatitis A and B, meningococcal and Hib). It also includes "catch-up vaccines" for adults who did not receive the currently recommended number of vaccines in childhood, such as multiple doses of the measles, mumps and rubella vaccine, and repeated doses of the DTaP (diphtheria and tetanus with pertussis now recommended for the first adult booster) and then TD (tetanus and diphtheria) every ten years. The current schedule also includes a DTaP vaccine for women during every single pregnancy.

While there is a perception that there are a large number of unvaccinated children in the United States, the NVP points out that childhood vaccination rates exceed 90% but that American adults "continue to be vaccinated at low and variable rates."

In other words, don't blame those non-vaccinating parents for the next pertussis outbreak. Far more adults are behind on vaccinations than children.

Between one half and two thirds of all adults have received a tetanus booster in the past ten years, but pertussis vaccination rates are between 8.7% of Hispanic adults to a high of 21.4% of "other races" (the pertussis vaccination rate is 16.1% for white adults). And despite the fact that children are not in the high risk groups for hepatitis B infection, most infants are vaccinated against the disease while the adult vaccination rate for hepatitis B is around 12%.

The plan lists current vaccination rates for each vaccine and target percentages.

For instance, in 2012, only 62% of health care professionals chose to get a flu vaccine. The NVP aims for 90% of health care professionals to get an annual flu vaccine by 2020.

The plan calls for many groups to work together to increase adult vaccination rates, including advocacy groups, tribal leaders, local and state governments, vaccine manufacturers, health care providers, employers, health plans, academia and the general public. Later in the plan, it also advises enlisting community groups and faith-based groups to encourage adult vaccination.

As part of its efforts to improve the adult immunization infrastructure, the NVP recommends increasing the use of two federal databases, "Electronic Health Records" (EHRs) and "Immunization Information Systems" (IIS), to collect and track adult vaccination data.

The plan also advises training health care providers to assess vaccination status and "strongly recommend" vaccines at every visit.

The plan acknowledges that vaccines are generally less effective in older adults and those with weakened immune systems, despite calling for increased vaccination rates for these groups. It calls for vaccine manufacturers to create new vaccines that will be more effective for these adults, as well as to develop vaccines that provide longer immunity and are better suited to vulnerable populations such as pregnant women and chronically ill adults.

The plan further calls for a new Adult Immunization Implementation Plan that will be developed by the Adult Interagency Task Force (AITF), a group created in 2009 which is "composed of core federal stakeholders with a vested interest in adult immunization."

Other goals for the plan include:

    For 50% of physicians to report adult vaccination to the IIS database by 2020.
    For 60% of pharmacists to report adult vaccination to the IIS database by 2020.
    For 100% of all states and territories to allow pharmacists to administer all recommended adult vaccines by 2020.
    For 100% of Medicaid programs to cover all expenses for all recommended adult vaccinations by 2020.

You can view the current adult vaccination recommendations here, and read more about them here.

If you do decide to get updated on your adult vaccinations, be sure to research each vaccine and contraindications beforehand. Remember that the National Childhood Vaccine Injury Compensation Program has paid out more than $3 billion dollars for vaccine damages and deaths, despite a years-long backlog and famously difficult application process. You can read more about the less publicized side of vaccinations here.

Right now, there is legislation pending all over the country to force compulsory vaccinations. Also remember that this legislation will not just affect infants and children, but may also determine whether you have any say in how many vaccinations you must receive each year and what those might be.