THE BLOG

Can We Be Adults About This?

02/06/2015 04:33 pm ET | Updated Apr 08, 2015

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There's a high price to pay for political posturing: our public health. As the debate around the anti-vaccination movement rages on, it is important to bear in mind that the vast majority of Americans, across party lines, believe that the benefits of vaccination outweigh the risks. According to the nation's leading researchers from the Center for Disease Control and the National Institutes of Health, Americans are making the right choice when they stay up to date with their vaccinations.

Unfortunately, despite the effectiveness of potentially life-saving preventive services, such as screenings and vaccinations, in 2013 only 25% of adults ages 50 to 64 and fewer than 50% of adults age 65 years or older were up to date. Politicians are making a mostly indisputable choice into a partisan hot potato about the reach of government and personal freedoms. By creating a debate around vaccinations politicians are generating more skepticism from adults, particularly adult women, who are making important decisions about not only their child's vaccinations, but their own. According to one study, the largest contributing factor to uncertainty about vaccinations was a "conspiratorial mindset". The political is detracting from the practical and undermining a proven prevention strategy: adult vaccinations.

For example, did you know that an average of 30,000 people die each year from vaccine-preventable illnesses? And that 95 percent of those who die are adults? Each year, an average of 226,000 people is hospitalized due to influenza and between 3,000 and 49,000 people die of influenza and its complications; the majority are adults.

Survey after survey indicate that adults are not getting the vaccinations they need.
The 2010 Adult Immunization report found millions of American adults go without routine and recommended vaccinations each year, which leads to an estimated 40,000 to 50,000 preventable deaths, thousands of preventable illnesses, and $10 billion in avoidable health care costs annually.

As the recent Disneyland measles outbreak has demonstrated, adults aren't the only ones who need the protection. While many of the illnesses adults contract aren't deadly for them, they can be fatal, and easy to pass on, to their children, grandchildren, nieces and nephews. It is critical that those in close proximity to infants be up to date on their vaccinations, especially since babies under a year old are too young to be immunized, making them extremely vulnerable. Take whooping cough: this respiratory infection causes a persistent cough in adults, yet it can be fatal for infants. No parent or grandparent ever wants to be responsible for infecting a child.

But if no one wants to put a child at risk, and the majority of Americans don't believe in a government vaccination conspiracy theory, then why are adult vaccination rates still so low?

There are plenty of barriers, starting with primary care physicians. A 2012 survey found that just 29% of general internists and 32% of family physicians assessed their patients' vaccination status at every visit. Only 8% of general internists and 36% of family physicians said they used immunization information systems.

Almost all physicians said they assessed the need for and stocked seasonal influenza, pneumococcal, tetanus and diphtheria, and tetanus, diphtheria, and acellular pertussis vaccines. Only 31% of family physicians and 20% of general internists reported stocking all 11 adult vaccines that were recommended for routine use in 2012.

A study released last year from the University of Colorado School of Medicine confirmed a failure of health care providers to assess the vaccination needs of their patients and an insufficient stock of vaccines. It also identified inadequate insurance reimbursement, record-keeping challenges, and high costs to smaller practices and general internists who see more Medicare Part D patients. "As the population ages this could easily grow into a more serious public health issue," said Dr. Laura Hurley, lead author of the study and an assistant professor of medicine at the CU School of Medicine.

Then there's the social contract. Unlike children's vaccinations, which are rigorously policed by schools, summer camps, youth sports leagues and more, adults are on their own. And while there is plenty of material available, it requires taking the time to find out what we need to know: What vaccination do I need? What about the other members of my household? Will my insurance cover them? If not, are there other resources available? Are there side effects that might make it tough to do my job? The burden of finding the answers to all these questions falls primarily on women, who make close to 85 percent of all household health-related decisions.

We do not yet know how to address all of the medical barriers or gaps in education surrounding vaccinations. What we do know is that there's empirical data demonstrating that adult vaccinations are a proven prevention strategy. What we do know is that the current inflammatory political climate is not constructive. What we do know is that we are all in this together. If we decide to, we know that, working together, we can prevent the preventable.