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Adult Vaccinations: Neglected Preventative Medicine

Posted Sep 29 2010 12:00am

The CDC believes that far too few adults are maintaining vaccinations or getting vaccinated at all. C.D.C. recommends that ALL people 19 and older receive immunizations against as many as 14 infectious diseases, while remembering that not all adults require every vaccine. Most of the time, adults rarely think about getting shots unless they are injured or plan travel to an undeveloped country.

For example, this year alone, over 11,000 cases of whooping cough (pertussis) have been reported nationwide. Infections are near record levels in California and 9 infants have died. No doubt some of these young children had not received all of their vaccinations.  Still, it is firmly believed that some of those deaths could have been prevented if more adults had also been immunized.

CDC studies currently show that only 7% of Americans over age 60 have received the herpes zoster vaccine to prevent shingles.  Shingles is a painful nerve infection which can become a chronic pain issue and cause debilitation. The widely publicized vaccine against the two types of human papilloma virus that cause 70% of all cervical cancers has to date only been received by an estimated 11% of young women.

More concerning is data from a study by the National Foundation for Infectious Diseases conducted in 2007 which showed that 40% responded that if they had been vaccinated as a child they no longer needed any other vaccinations.  Even worse is that some 18% said that vaccines were not necessary for adults at all.

One aspect of the new health care law should be of some help in removing barriers that may be keeping adults away from vaccinations.  The new health plan mandates that group and individual health plans along with Medicare provide preventive health services, including immunizations recommended by the C.D.C., at no charge. For insured persons, that will mean no co-payments, co-insurance or deductibles. However, that is not the entire story. If your insurance is through a group or individual health plan, your plan must be new, or have been substantively changed, in order for the new requirements to apply. Also, some of the CDC recommendations, those which are most recent, will not be covered initially.

From the standpoint of disease prevention, vaccines are cheap.  One trip to the emergency room due to a significant case of the flu or pneumonia can generate bills totally in the thousands of dollars. Flu shots are almost always to be found for about $20 and for many individuals, are often found at no charge.  Pneumonia vaccines cost around $70 to $80 versus potentially much more if you get pneumonia.

Many local pharmacies, including most of the large chain pharmacies offer vaccinations.  Some even have so-called “retail clinics” and administer a wide range of vaccines.  The most well known include CVS MinuteClinics and Walgreens Take Care Clinics. A wide range of vaccines can be obtained at these pharmacies.  Prices vary but some examples include: hepatitis A ($110-$120) and B ($100-$110), meningitis ($140-$150), pneumonia ($70-$80) and DPT (diphtheria, pertussis and tetanus ($80-$90). There are literally thousands of pharmacies nationwide offering these services, with many open daily.  Usually appointments are not necessary nor are prescriptions.  Some larger chains even offer travel vaccines with specified lists for defined areas of travel. In all states, pharmacists are licensed to give flu shots after taking some basic courses.  Many states allow pharmacists to administer a full range of vaccines as well.

This raises the question, why can’t I get these shots from my doctor? In many cases you can, but increasingly, the cost of vaccines are not covered for physicians at a rate commensurate with what they must pay.  Also, administration costs are barely if at all covered by many insurers.  Recently, flu shots were available at the local family doctor here, but were not “advertised” and given only if established patients asked.  This was actually done as a courtesy. So it would appear that vaccines have made the jump to the public health arena completely.  This is good news overall, as the broader the range of persons vaccinated against communicable disease, the better for all, regardless of age. This is especially true in an age where inter-continental and international travel occur thousands of times daily . . . jomaxx and obi jo

Cost and Lack of Awareness Hamper Adult Vaccination Efforts – http://www.nytimes.com/2010/09/25/health/25patient.html?_r=1&emc=tnt&tntemail0=y

Saving Lives:Integrating Vaccines for Adults into Routine Care – http://www.nfid.org/pdf/publications/adultimmcta.pdf

Grantee Immunization Websites – http://www.cdc.gov/vaccines/spec-grps/prog-mgrs/grantee-imz-websites.htm

Vaccinations for Adults:You’re NEVER too old to get immunized! – http://www.immunize.org/catg.d/p4030.pdf

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