Reminder Systems and Strategies for Increasing Adult Vaccination Rates

An important component of an immunization provider practice is ensuring that the vaccines reach all adults who need them. While attention to appropriate administration of vaccinations is essential, it cannot be assumed that these vaccinations are being given to every eligible person at the recommended age.

Specific concerns about U.S. immunization levels and areas for further study include the following:

• Immunization rates among adults are considerably lower than those for children.
• Economic and racial disparities exist.
• Rates of influenza immunization are also low among some healthcare providers, an important target population for vaccination.
• Improvements in adult immunization rates have tapered off.

This page offers many resources and publications describing the need for increasing adult immunization levels and outlines strategies that providers can adopt to increase coverage in their own practice.

 

The Task Force on Community Preventive Services

• The Guide to Community Preventive Services is a free resource to help you choose programs and policies to improve health and prevent disease in your community. Systematic reviews are used to answer these questions:
  • Which program and policy interventions have been proven effective?
  • Are there effective interventions that are right for my community?
  • What might effective interventions cost; what is the likely return on investment?

Learn more about The Community Guide, collaborators involved in its development and dissemination, and methods used to conduct the systematic reviews and overall vaccination strategies.

 

Task Force Recommendations and Findings

This table lists interventions reviewed by the Community Guide, with a summary of the Task Force finding (definitions of findings). Click on an underlined intervention title for a summary of the review.

 

Enhancing Access to Vaccination Services

• Home Visits to Increase Vaccination Rates
• Reducing Client Out-of-Pocket Costs

 

Increasing Community Demand for Vaccinations

• Client or Family Incentive Rewards
• Client Reminder and Recall Systems
• Community-Based Interventions Implemented in Combination

 

Provider- or System-Based Interventions

• Adult Vaccinations: Team-Based Immunization (American Medical Association)
• Health Care System-Based Interventions Implemented in Combination
• Immunization Information Systems
• Provider Assessment and Feedback
• Provider Reminders
• Standing Orders

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CDC Sources

• “Immunization Strategies”: CDC’s strategies that lead to high immunization levels in a practice
  Chapter 3 in the “Pink Book” May 2012 – Explains the need for strategies to increase immunization rates, the AFIX approach (assessment, feedback, incentives, eXchange), and other essential strategies such as recordkeeping, recommendations and reinforcement, reminder and recall to patients and providers, reduction of missed opportunities and barriers to immunization.
• Immunization Information Systems
  Many recordkeeping tasks, as well as patient reminder/recall activities, can be greatly simplified by participation in a population-based immunization information system (IIS), also known as an immunization registry.
• Recommendations of the ACIP: Programmatic Strategies to Increase Vaccination Rates — Assessment and Feedback of Provider-Based Vaccination Coverage Information (published 1996; historical document)

 

External Sources

• Checklist: Suggestions to Improve Your Immunization Services [2 pages] June 2008 Immunization Action Coalition
  For healthcare professionals to improve they efficiency in administering vaccines and increase their immunization rates.
• Strategies for Improving Health Care Personnel Influenza Vaccination Rates [1 page] April 2012
  The Joint Commission

 

Publications/Articles

Cost-effectiveness needs more research. More research is needed regarding which strategies increase immunization levels with the least expenditure so these strategies can be prioritized.

Sustainable systems for vaccinating adults must be developed. High immunization rates cannot rest upon one-time or short-term efforts. Greater understanding of strategies to increase and sustain immunization levels is necessary in order to create lasting, effective immunization delivery systems.

A few of the articles published on this topic are listed below.

• Association of a Best-Practice Alert and Prenatal Administration With Tetanus Toxoid, Reduced Diphtheria Toxoid, and Acellular Pertussis Vaccination Rates
  Obstet Gynecol; 2015;126:333–7
• Evaluation of a Toolkit to Introduce Standing Orders for Influenza and Pneumococcal Vaccination in Adults: A Multimodal Pilot Project
  Vaccine; 2012;30(41):5978-82
• Text Message Reminders to Promote Human Papillomavirus Vaccination
  Vaccine, 2011;29(14):2537-41
• IDSA’s policy to strengthen adult and adolescent immunization coverage Infectious Diseases Society of America (IDSA)
  lin Infect Dis; 2007;44:1529-1531
• Adult Immunization: What Can We Learn from the Childhood Immunization Program?
  Clin Infect Dis; 2007;44:1532-1535

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