Adult vaccination infrastructure faces growing pains

The number of immunizations available for people 18 and older is on the increase, but delivery mechanisms are not as robust as they are for children.

By Victoria Stagg Elliott, AMNews staff. March 19, 2007.

Developing new adult vaccines may have been the easy part.

Experts are now pointing out what is creating another level of difficulty: The structure to provide immunizations to adults is insufficient for delivering the shots that have long been available and woefully inadequate for incorporating new preventives.

"It's abysmal -- our ability to deliver influenza vaccines to young adults at high risk. We still need to immunize adults against pneumococcal disease, and we are doing a terrible job," said Neal A. Halsey, MD, director of the Institute for Vaccine Safety at Johns Hopkins Bloomberg School of Public Health in Baltimore. "And new vaccines are creating new opportunities and new challenges."

To address this issue, as well as others related to childhood vaccinations, the American Academy of Pediatrics and the American Medical Association organized the first National Immunization Congress, held Feb. 27 to March 1 in Chicago.

"Physicians find increasing challenges with immunization access and delivery," said AMA President-elect Ronald M. Davis, MD. And one of the tasks with which physicians and public health officials are struggling is how to overcome those trials to get the vaccines into the arms of grown-ups.

Among strategies offered by attendees was the establishment of a "Vaccines for Adults" program, much like the government-funded one for children, to provide shots to those who are uninsured and older than 18. Also, most agreed that insurance should always cover this preventive service.