Ms Zimlich is a freelance writer in Cleveland, Ohio. She writes regularly for Contemporary Pediatrics, Managed Healthcare Executive, and Medical Economics.
Researchers and physicians are working together to discover why adults skip recommended vaccines and what doctors can do to increase immunization rates.
It’s no surprise that many adults don’t get the vaccinations they should. Now, a new initiative out of Duke University in Durham, North Carolina, aims to find out why immunization rates among adults is so low and what healthcare providers can do about it.
The new collaborative launched at the Duke Clinical Research Institute (DCRI) and Duke Primary care aims to foster the development of evidence-based interventions to support adult vaccination practices. The program, called the Adult Immunization Project, will focus on working with providers throughout the Duke Health system.
Adult vaccination rates remain low for a wide range of vaccine-preventable diseases, despite the fact that nearly 50,000 Americans still die each year from vaccine-preventable diseases or complications of those diseases, according to a statement from DCRI.
“Less than half of all eligible adults in the U.S. get an annual flu vaccination, which is one of the more common vaccines. The rates of vaccinations for other diseases, such as shingles and pneumonia, are even lower,” said Tracy Y. Wang, MD, MHS, MSc, associate professor at Duke University, and director at the Duke Clinical Research Institute Education and the Duke CTSA Recruitment Innovation Center, in a statement about the program.
Wang said as part of the program, researchers will analyze educational interventions used in primary care practices throughout the Duke system to try and understand which were successful and why. Frontline staff will be tasked with improving patient awareness in an effort to boost immunization compliance, she said.
The data will then be fed into an analytics platform where healthcare providers will be able to see in a single view a patient’s vaccination status, identify high-risk patients and connect patients with targeted interventions.
Wang said she is hopeful the program will identify ways to help physicians better manage adult immunizations and, in the end, increase compliance.
“As physicians, we all know that immunizations are important and worth doing; the problem is time,” Wang told Medical Economics. “How do we prioritize discussions about immunizations when taking care of patient concerns and active health issues?"
“This initiative offers this answer: we can do this via a team-based approach that is grounded in data. Team-based approach means not placing the onus on a single provider, but ensuring all members of the medical team who interact with the patient, from check in to departure, to buy into the need for immunization and make sure that it happens.”
Interactions may include cultivating conversational cues about vaccines, making sure providers respond appropriately to questions or concerns and offering assistance to patients unsure how to may for the vaccine or arrange insurance coverage.
Another piece of the puzzle is getting accurate data on adult immunization practices and obstacles, and helping patients navigate the process, she said.
“Data helps this engine run. We need accurate data on immunizations, whether the patient gets it in the clinic or their local pharmacy. Providers get competitive when they’re benchmarked against their peers,” Wang said. “Finally, data are necessary to demonstrate the gaps that need to be closed.”
The first step for primary care physicians, Wang said, is to acknowledge there is a problem.
“Fundamentally, we start by addressing the knowledge gap-why, who, when and how to appropriately vaccinate patients – for clinician and non-clinician providers. Then we build on that to train our personnel on how to have conversations with patients about immunization, including common concerns and how to address them,” Wang explained. “We surveyed providers on barriers to immunization and are developing interventions that target revealed gaps. For example, insurance barriers are present for some of the vaccines; so education is designed to help patients get approval for those vaccines.”