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Many adults aren’t getting their vaccines: How to report on this trend

AHCJ Staff

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By Eileen Beal and Bara Vaida

In the United States, far too many people – including many older adults – don’t get what they need to keep them from getting and spreading vaccine-preventable diseases. Yet the National Adult Vaccination Program says there are 50,000 vaccine-preventable deaths in the United States each year.

(A note: The term “vaccine-preventable diseases” is medically correct, but can a disservice to readers. Many of these diseases are infectious, communicable and, in many cases, deadly.)

Why aren’t people getting vaccinated?

Cost and access, plus ethnic, racial and geographic disparities play a role. So does complacency. Tom Frieden, M.D., M.P.H., former director of the Centers for Disease Control and Prevention, laments the fact that far too many people think “that infectious diseases are over in the industrialized world.” He points out that global travel and trade can spread infectious diseases “anywhere within 24 hours.”

Many adults do not realize that vaccinations don’t just keep the disease they are given for at bay but also can help prevent other, often deadlier medical complications. The CDC says vaccinations can reduce the risk of cervical and liver cancer, hospitalization from the flu and flu-related heart attacks.

Why is the vaccination situation particularly bad for seniors?

  • Well over half of those 50,000 deaths occur in older adults, according to the Centers for Medicare and Medicaid Services.
  • An older adult’s declining immune system needs vaccines to boost its infection-fighting ability.
  • Older adults are often dealing with multiple conditions that increase the risk for and severity of vaccine-preventable diseases.
  • Older adults often are live with situations – on fixed incomes, in rural areas, without transportation, cognitively impaired, etc. – that make getting vaccinations difficult.
  • They need the “herd immunity.”

Why the vaccination situation bad for the nation?

Adult vaccine-preventable diseases cost the country in the range of $4.7 billion to $15.2 billion in medical expenses and lost productivity, according to a November 2016 report in Health Affairs. This probably is among the reasons that the Health and Human Service’s Office of Disease Prevention and Health Promotion added older adult-specific vaccination goals to its Healthy People 2020 project.

It also may be one reason that in the past couple of years there has been an increase in the number of organizations focused on public education about vaccinations and lobbying at the state and federal level for sounder policies and financial support for vaccination programs. Among the most active groups are the National Adult Vaccination Program, the Immunization Action Coalition, Trust for America’s Health and the Adult Vaccine Access Coalition.

What vaccinations do seniors need?

The CDC’s Adult Immunization Schedule is the bible for adult vaccinations and will, along with Vaccines.com, provide useful information for reporting on seniors’ vaccination requirements. Also, it provides excellent background and analysis related to immunization trends – and challenges.

Story ideas

Given the aging of the population and the considerable impact the nation’s poor vaccination rates have on older adults’ health and quality of life, the what-to-write landscape is packed with possibilities:

  • A get-people-thinking article on the medical, quality-of-life and financial reasons that older adults/seniors should get their yearly vaccinations and have their recommended vaccinations up to date. Report on the physical, emotional and financial impact that not being vaccinated can have on them and their families. For background, talk to a few geriatricians and read this CDC Health Aging in Action strategy report.
  • A primary goal of the Affordable Care Act was to expand preventive care, coverage and funding. With the ACA under threat, consider an article on how the law may have improved vaccination rates – especially for older adults who make too much to qualify for Medicaid-funded health care but are too young to qualify for Medicare – and how elimination could lead to more preventable diseases. See this recent story in Scientific American.
  • With the aging of the population, cases of shingles – an age-related condition – is skyrocketing. However, despite the fact that the shingles vaccine is covered under many private health plans, through Medicare Part D, and through some state’s Medicaid programs, only 20 percent of those eligible for it have gotten the shot. This year the FDA approved a new shingles vaccine that is considered more effective. Find out what the current shingles incidence and vaccination rates are in your area. Ask whether those providing vaccinations (primary physicians or a drug store) are offering the new vaccine and why so few adults are getting the vaccine. Looks at what GSK, which produces the vaccine, and the local health care community are doing to promote the vaccine’s use. Be sure to include mention of the side effects and risk of the vaccine. For background, see this New York Times article and this skeptical story by Health News Review.
  • According to a recent CDC report, for the 2017-2018 flu season, 56.6 percent of those over 65 got a flu shot. Using the CDC data in the report, find out where your state stands in the ranking; how those in your state’s public health arena view your state’s ranking; what city, county and state agencies plan for next year to improve their flu and other vaccination rates. The CDC’s FluVaxView has good data on the topic.
  • States are ground-zero for many immunization initiatives. To see one such campaign, look at this example at Caregiving.org. Get details on your state health department’s immunization programs and initiatives.
  • One reason older adults may not be getting needed vaccinations is that their health care provider is not making the suggestion. This 2013 report provides information on what health care providers should be doing to “encourage and incentivize providers and increase immunization rates.” The Immunization Action Coalition has useful information.
  • If you cover the business of health, write about the positives and negatives of workplace immunization programs. Look at who is doing them; how they are received and what bottom-line benefits are or are not being seen by providing workplace immunizations. An excellent source on these programs is the Association of State and Territorial Health Officials.
  • Americans have grown complacent about communicable diseases and the important role vaccinations can play in their personal health and that of their community. When there is an outbreak of a contagious disease (as there was in Kansas in April) report on the extent to which complacency can contribute a decline in “herd immunity,” the increase in communicable diseases, and ultimately more significant exposure to and deaths from communicable diseases for older adults.

Resources

What to read

Sources

Eileen Beal is a Cleveland-based independent journalist who specializes in covering aging and consumer-focused health and wellness issues. This tip sheet was researched and written with the support of a 2013 MetLife Foundation Journalists in Aging stipend administered through New America Media and the Gerontological Society of America. This tip sheet was updated in 2018 by Bara Vaida, AHCJ’s infectious disease topic leader. She writes blog posts, tip sheets, articles and gathers resources to help members cover this complex topic.

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