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Medical News and Perspectives |

Physicians’ Offices Play Key Role in Promoting Vaccination to Adult Patients

Rebecca Voelker
JAMA. 2012;307(6):552-552. doi:10.1001/jama.2012.93
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Pharmacies and retail medical clinics increasingly offer some routine immunizations, but a new report says that most adults are vaccinated at physicians' offices. As the leading source of adult immunizations, office-based health professionals may be able to boost low rates of adult vaccinations by following recommendations provided in the report.

“Regardless of where vaccines are actually administered, office-based providers are uniquely positioned to identify patients who need vaccination, to communicate credibly about the benefits and risks of vaccination, and to ensure that vaccination histories are properly maintained,” said Katherine Harris, PhD, the report's lead author and a senior economist at RAND, the nonprofit research organization that published the report (http://tinyurl.com/7xs24n4).

The report notes that in 2009, 44% of the 160 million US adults for whom influenza vaccination was recommended were not vaccinated and didn't plan to be immunized. However, 20% of those adults said they would be vaccinated if a health professional strongly advised it.

To increase the number of office-based practices that offer all recommended adult vaccinations—only 27% do so now, according to the report—a decision tool should be developed for physicians to determine whether they can install temperature-controlled storage and maintain inventory, the authors said. For practices that offer all adult vaccinations, the report called for the development of structured vaccination counseling protocols and guidance for physicians whose adult patients have missing or incomplete vaccination histories.

Pharmacies and retail clinics that provide vaccinations offer medical offices more opportunities to refer patients. The report suggests that referrals be formalized by including the recommended vaccinations, the locations and hours of community vaccination providers, how to document such common immunizations as flu vaccine that patients get on their own at a pharmacy or retail outlet, and how documentation of vaccinations should be returned to the referring physician.

Several steps also could help encourage performance-based payment for vaccinations. The report suggests applying for procedure codes specific to vaccination counseling and using national surveys and checklists in office-based practices to determine how well health professionals promote vaccinations and keep patients fully vaccinated.

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