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Report: Thousands of Unvaccinated Adults Die From Preventable Diseases

Financial barriers, insurance, communication among problems (February 4)

While adults make up 95% of those who die annually from vaccine-preventable diseases, a new study from the University of Colorado School of Medicine shows that their vaccination rates remain stubbornly low, representing a growing public health concern.

The study, published in the Annals of Internal Medicine, is the first to examine several important aspects of adult vaccination. Lead author Laura Hurley, MD, MPH, and her colleagues designed a national survey of primary care physicians to look at how doctors assessed patients’ vaccination status and stocked the 11 recommended adult vaccines in 2012.

“Physicians reported a variety of barriers to vaccine stocking and administration, but financial barriers dominated the list,” the study says. “Physicians in smaller, private practice often assume more risks from stocking expensive vaccine inventories and may be particularly affected by these financial barriers.”

According to Hurley, many doctors expressed difficulty getting reimbursed by insurance for vaccines. For example, the herpes zoster vaccine has been recommended since 2008 but is not widely stocked by physicians.

One major reason for this, the study says, is that zoster is covered by Medicare Part D, a pharmaceutical benefit, and physicians report problems with reimbursement. At the same time, the vaccine can require substantial out-of-pocket costs for patients, making it less attractive to them, as well.

As a result of these difficulties, many physicians are referring patients to pharmacies or public health facilities for vaccinations.

There were also problems coordinating vaccine records when done by someone who is not the patient’s primary care physician.

Source: University of Colorado Denver; February 4, 2014.

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