August 13, 2018
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Gaps found in adult vaccination referrals, administrations

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Implementation of the Standards for Adult Immunization Practice varied substantially by vaccine and provider type, according to findings recently published in the American Journal of Preventive Medicine.

“Although previous studies have reported on assessment, recommendation and administration practices for adult vaccination among primary care physicians, the present study also included OB-GYNs, subspecialists and pharmacists, and assessed multiple vaccine types,” Chelsea S. Lutz, MPH, of the Immunization Services Division at the CDC and colleagues wrote.

Researchers analyzed survey responses from 261 pharmacists and 1,714 clinicians regarding their or their support staff’s vaccine administration or referral for eight different vaccines. Of the clinicians, 30.7% were family physicians, 25.5% were internal medicine practitioners, 23.6% OB-GYN, and 20.2% subspecialists.

Lutz and colleagues found that more than 80% of providers assessed for and recommended the influenza vaccine, but 48.9% of subspecialists and 24.3% of the OB-GYNs did not stock influenza vaccine for administration. In addition, although more than 89% of PCPs recommended the herpes zoster vaccine, less than 58% stocked the vaccine. However, 91.6% of pharmacists stocked herpes zoster vaccine.

Other differences between implementation and provider type included 91.2% of OB-GYNs recommended the HPV vaccine vs. 68.6% of internal medicine respondents; more family medicine respondents than OB-GYN respondents indicated they recommended hepatitis B (78.9% vs. 31.6%) and tetanus and diphtheria toxoids (73.6% vs. 23.4%) vaccines. Also, 80.7% family physicians kept 13-valent pneumococcal conjugate in stock vs. 88.8% of pharmacists, with the numbers for these professionals stocking the 23-valent pneumococcal polysaccharide at 79.2% vs. 88.8% and tetanus-diphtheria-acellular pertussis vaccines at 88.8% vs. 78.2%.

“This analysis highlights ... the need to ensure communication among providers regarding vaccinations provided and vaccination needs of their adult patients. It also highlights the need to maintain the capacity of health departments and pharmacies to provide vaccinations for adult patients whose medical provider does not stock one or more recommended vaccines. Improvements to vaccination coverage among adults may be achieved by increasing provider implementation of the [Standards for Adult Immunization Practice],” Lutz and colleagues concluded. – by Janel Miller

Disclosure: The authors report no relevant financial disclosures.