Adults need vaccines to protect from preventable diseases, say medical societies

Nov 19 2008

The American College of Physicians (ACP) and the Infectious Diseases Society of America (IDSA) have released a joint statement on the importance of adult vaccination against an increasing number of vaccine-preventable diseases.

The statement has been endorsed by 17 other medical societies representing a range of practice areas.

According to the Centers for Disease Control and Prevention, 95 percent of vaccine-preventable diseases occur in adults and more than 46,000 adults die of vaccine-preventable diseases or their complications.

"It is crucial for physicians -- internists, family physicians, and subspecialists who provide primary and preventive care services for patients, especially those with chronic diseases -- to discuss and review their adult patients' vaccination status and either vaccinate them or provide a referral for recommended vaccines," said Jeffrey P. Harris, MD, FACP, president of ACP. "We believe that the Patient-Centered Medical Home model of care -- which in coordination with the other components of the health care delivery system is the future of health care -- will help to increase immunization rates among adults."

"Thanks to immunization, most children never suffer from vaccine-preventable diseases but that's not true for their parents or grandparents," said William Schaffner, MD, FIDSA, MACP, chair of IDSA's Immunization Work Group. "Every year, hundreds of thousands of adults get sick, miss work, and are hospitalized. Many adults die because of vaccine-preventable diseases or their complications. Costs associated with treatment run in the billions."

Adult vaccination rates range from 26 to 69 percent, depending on the vaccine and specific target group. ACP and IDSA plan to work with the other medical societies toward facilitating access to tools and resources to help physicians encourage adult immunization amongst their patients.

The joint statement includes the following five proposals:

• Primary and subspecialty physicians should conduct an immunization review at appropriate adult medical visits to educate patients about the benefits of vaccination and to assess whether the patient's vaccination status is current, referring to the Advisory Committee on Immunization Practices Adult Immunization Schedule.
• When appropriate, physicians should provide or refer patients for recommended immunizations.
• Physicians who administer vaccines should ensure appropriate documentation in the medical record. In addition, documentation of vaccination in other settings, patient refusal and any contraindications is advisable. The use of immunization registries and electronic data systems facilitates access to accurate and complete immunization data.
• Physicians who refer patients for vaccination also should review and document the vaccination status of their patients whenever possible.
• Consistent with the CDC Advisory Committee on Immunization Practices and multiple subspecialty organizations, physicians and their staff should be immunized consistent with CDC recommendations, with particular attention to annual influenza immunization.

The list of vaccines that adults should discuss with their physicians includes influenza, pneumococcal, tetanus-diptheria-pertussis, hepatitis A, hepatitis B, measles-mumps-rubella, chickenpox (varicella), meningococcal, human papillomavirus, and shingles (zoster). Specific recommendations vary depending on age and other factors.