Immunization:

HHS Could Do More to Increase Vaccination Among Older Adults

PEMD-95-14: Published: Jun 8, 1995. Publicly Released: Jul 10, 1995.

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Pursuant to a congressional request, GAO reviewed immunization rates among the elderly for influenza and pneumococcal diseases, focusing on the: (1) Department of Health and Human Services' (HHS) efforts to improve the use of these vaccines; and (2) types of interventions that enhance the use of these vaccines.

GAO found that: (1) although the use of pneumococcal and flu vaccines among the elderly has more than doubled in the past 10 years, immunization for both diseases remains low; (2) in the 14 years since Medicare authorized coverage for pneumococcal vaccination, HHS has done little to enhance its use aside from providing Medicare payment; (3) although antibiotic resistance to pneumococcal bacteria is increasing, it is unlikely that HHS will reach its vaccination goal of 60 percent by 2000; (4) although HHS has made major efforts to enhance the use of the flu vaccine, HHS is discouraged from spending more of its immunization funding on the elderly; (5) HHS may reach its 60-percent flu immunization goal by 2000, since vaccination rates have steadily increased since 1989 and HHS plans to enhance its promotional strategies; (6) although the Centers for Disease Control has typically spent very little on adult immunization services, it is important to increase spending to raise immunization rates and save lives; (7) efforts to improve health care providers' compliance with adult immunization guidelines are promising; and (8) the implementation of a hospital policy to vaccinate eligible high-risk patients before discharge may reduce vaccine-preventable mortality among adults.

Recommendations for Executive Action

  1. Status: Closed - Not Implemented

    Comments: A CDC official stated that a decrease in funding of state immunization program grants had forced concentration of efforts on childhood immunization. However, unspent surpluses from previous years were also cited as a reason for reducing these grants.

    Recommendation: The Secretary of Health and Human Services should take a more active leadership role in promoting pneumococcal and influenza vaccination among elderly persons by seeking, in the annual appropriations process, to clarify what proportion of immunization funding should be allocated for such activities.

    Agency Affected: Department of Health and Human Services

  2. Status: Closed - Not Implemented

    Comments: No action is intended.

    Recommendation: The Secretary of Health and Human Services should take a more active leadership role in promoting pneumococcal and influenza vaccination among elderly persons by directing the Health Care Financing Administration and the Public Health Service to focus their efforts on promoting or supporting promising strategies, such as patient and physician reminder systems, development of standing order policies, and broad-based use of a hospital policy to vaccinate eligible patients before discharge.

    Agency Affected: Department of Health and Human Services

 

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