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A new study finds that adult vaccination rates are "stubbornly low", leading to many preventable deaths each year. Why?

Vaccine rejectionism — where parents opt out of routine vaccinations for their children — is on the rise. Those who reject vaccines often feel extremely strongly about the issue, and one of their more common arguments is that vaccine-preventable diseases are simply not dangerous in developed western nations. 

A belief in alternative healthcare isn't the only reason people don't get their shots, though. Many adults are just not aware that booster shots are recommended on a regular basis, and the authors of a new study now warn that "stubbornly low" vaccination rates in adults are becoming a public health concern. 

The large number of inappropriately-vaccinated does send a chilling message to vaccine rejectionists, however: 30,000 people die from vaccine-preventable diseases in the United States every year. 

Why Are Adult Vaccination Rates So Low?

Dr Laura Hurley, assistant professor of medicine at the University of Colorado (CU) School of Medicine, and her colleagues looked at the immunization status of American adults in 2012 with the help of the Centers for Disease Control and Prevention (CDC). They examined how primary care physicians determined whether adults were up to date on their vaccines, and inquired if physicians stocked all 11 recommended adult vaccines. 

The survey lead to some interesting discoveries:

  • Only 65 percent of adults over 65 get their flu shots
  • Only 62 percent got the pneumococcal vaccine
  • A mere 20 percent of high-risk adults aged 19 to 64 received a pneumococcal vaccine
  • Shingles was even less of a priority: only 16 percent of adults over 60 got their herpes zoster shot
Dr Hurley explains that "missed opportunities for adult vaccination are common", as patients' vaccine status is not questioned during every medical appointment. She also adds that "most physicians are not stocking all recommended vaccines".

Why are adults not getting the vaccines that are recommended for them? The answer may lie in the doctor's office, rather than with patients themselves. Dr Hurley and her team concluded that financial barriers represent a large portion of the problem with adult vaccination rates, but not in the way you might think — we're talking about financial risks for doctors.

"Physicians in smaller, private practice often assume more risks from stocking expensive vaccine inventories and may be particularly affected by these financial barriers," the authors of the new study, which was published in the Annals of Internal Medicine, write. Physicians reported they encountered difficulties in getting reimbursed by insurance companies for vaccines. 

Herpes zoster, commonly known as shingles, is caused by the varicella zoster virus. Though this is the same virus that causes chickenpox, the symptoms are often much more severe. Shingles can lead to chronic nerve pain, occular inflammation, and even vision loss.

Shingles is not a virus you want to catch, and the good news is that it is vaccine-preventable and covered by Medicare Part D. Why is the vaccination rate so low, then? Doctors cited reimbursement issues as the reason for not stocking the vaccine at all, thereby cutting many patients off from the practical possibility to be immunized

Accessing The Recommended Vaccines

Back to that death figure. Thirty-thousand preventable deaths a year. In the United States of America. That is a shocking number if there ever was one. It's no surprise that the authors of this study want to know what can be done to improve that situation. 

They suggest using a confidential database to track vaccine rates in specific areas, and say this could help doctors remain aware of the vaccination statuses of their individual patients

"I feel we need to take a more systematic approach to this issue," Dr Hurley says."As the population ages this could easily grow into a more serious public health issue."

Under the Affordable Care Act, private insurance companies are obliged to cover recommended vaccines without co-pays when they are given by in-network providers. Those financial barriers that were mentioned should not, in other words, have to exist at all.  

The study's authors conclude that improving adult vaccination rates will "require increased use of evidence-based methods for vaccination delivery and concerted efforts to resolve financial barriers". In the meantime, individual patients can see their physicians and insist on all the recommended immunizations. 

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