185. Community Immunity Starts with You: The NP’s Guide to Adult Vaccinations

Thank you, Alicia and Patty, for sharing your impactful stories with us today.

Your experiences are a strong reminder of the importance of vaccinations and the diseases that they can prevent.

When we think about vaccines, we need to remember that it's important to vaccinate across the lifespan.

We remain at risk throughout our life.

And adult immunizations remain a critical and yet an underutilized component of our preventive care in the United States.

And despite the availability of safe and effective vaccines, we continue to have millions of adults who are unprotected against vaccine-preventable diseases, which we refer to as VPDSs.

So what is the role of the nurse practitioner? Well, first of all, adult immunization doesn't happen unless someone takes ownership.

And in many cases, that is someone is going to be the nurse practitioner.

Some recent data has shown us that about 53% of the primary care providers in the United States are nurse practitioners or PAs.

So what can NPs do to improve this? Well, MPs are uniquely positioned to assess the vaccination status across the lifespan, to identify any gaps during the routine care visits, or if you're in a specialty practice, to determine what vaccines that person is missing and get them to someone who can provide those vaccines.

As NPs, we need to deliver strong and clear vaccine recommendations, and we need to be willing to address and take the time to help patients navigate any concerns or hesitancy.

So I want to begin by taking a closer look at the role of vaccination in public health and where our adult immunizations continue to fall short.

Vaccinations have been touted as one of the greatest public health achievements in modern medicine.

We still do a pretty good job with childhood vaccines.

However, we don't do as good a job with adults.

Greater than 90% vaccine uptake has been reported for childhood vaccines, but adult vaccines are suboptimal due to several different factors.

So some of the different factors include fragmented care.

So many of our adults may lack a primary care provider or they may have inconsistent care where they're receiving care from different specialists and there's no coordination.

They have fewer preventive visits.

We see this throughout childhood and adolescence where we have more anticipatory guidance through those childhood years, but we start to see a drop off with young adults and older adults.

There's also a real lack of centralized tracking systems.

So vaccines that are received for the adult may not go into any type of a reporting system.

And also, a lot of times, adults don't perceive that they're at risk.

When I've asked patients if they're up to date on their vaccines, I typically hear stories that, yeah, I'm up to date on my vaccine, but as I start to drill down to individual vaccines, they say, well, I had all my vaccines as a child.

Do I need additional vaccines? So let's talk about some of the biggest drivers behind some of the low adult vaccination rates.