Manifesto on the Value of Adult Immunization: “We Know, We Intend, We Advocate”

Immunization through vaccination is a milestone achievement that has made a tremendous contribution to public health. Historically, immunization programs aimed firstly to protect children, who were disproportionally affected by infectious diseases. However, vaccine-preventable diseases can have significant impacts on adult mortality, health, and quality of life. Despite this, adult vaccinations have historically been overlooked in favor of other health priorities, because their benefits to society were not well recognized. As the general population is aging, the issue of vaccination in older adults is gaining importance. In high-income countries, recommendations for the routine vaccination of older adults have been gradually introduced. The Italian National Immunization Plan is considered to be among the most advanced adult vaccination plans in Europe. However, available data indicate there is low adherence to vaccination recommendations in Italy. The COVID-19 pandemic has exposed the damage that can be caused by an infectious disease, especially among adults and individuals with comorbidities. The aim of this “Manifesto”, therefore, is to provide an overview of the existing evidence on the value of adult vaccination, in the Italian context, with a call to action to healthcare providers and health authorities.

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Developing Adult Vaccination Ecosystem in India: Current Perspective and the Way Forward

Health Services Research and Managerial Epidemiology ◽

10.1177/23333928211030791 ◽

2021 ◽

Vol 8 ◽

pp. 233339282110307

Author(s):

Canna Jagdish Ghia ◽

Gautam Sudhakar Rambhad

Keyword(s):

Insurance Coverage ◽

Healthcare Providers ◽

Successful Implementation ◽

Vaccine Preventable Diseases ◽

Current Perspective ◽

Adult Vaccination ◽

Government Hospitals ◽

The Government ◽

Low Coverage ◽

Adult Immunization

Introduction: A high burden of vaccine-preventable diseases, increasing elderly population, immunosenescence, and emerging drug resistance emphasize the need for robust adult immunization in India. While immunization guidelines from various societies exist, there is inadequate implementation of the same. Aim: We undertook this narrative review of the adult vaccination ecosystem in India to (i) gain insights into existing adult vaccination practices, (ii) identify barriers to adult vaccination and possible solutions, and (iii) improve collaboration between various stakeholders to help establish adult vaccination centers in the country. Results: Besides the high cost and lack of insurance coverage, the lack of adult vaccination centers contributes to the low coverage of adult immunization. Discussion: These challenges can be addressed through multiple approaches including community awareness and immunization programs, setting up mobile vaccination vans, patient/consumer education, and adequate training of healthcare providers. Successful implementation of these strategies requires active collaboration between the government, hospitals, different stakeholders, and policymakers.

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Resurgence of Vector-Borne and Vaccine-Preventable Diseases in Venezuela in Times of a Complex Humanitarian Health Crisis: A Regional Menace

Prehospital and Disaster Medicine ◽

10.1017/s1049023x1900030x ◽

2019 ◽

Vol 34 (s1) ◽

pp. s5-s6

Author(s):

Adriana Tami ◽

Maria Eugenia Grillet ◽

Alberto Paniz-Mondolfi ◽

José Oletta ◽

Martin S Llewellyn ◽

...

Keyword(s):

Essential Medicines ◽

Malaria Surveillance ◽

Complex Situation ◽

Health Crisis ◽

Vaccine Preventable Diseases ◽

Health Authorities ◽

National Immunization ◽

Healthcare Crisis ◽

Vector Borne ◽

The Impact

Introduction:Venezuela has plunged into a humanitarian, economic, and health crisis of extraordinary proportions. This complex situation is derived from dismantling of structures at the institutional, legal, political, social, and economic level affecting the life and wellbeing of the entire population.Aim:This study aims to assess the impact of Venezuela’s healthcare crisis on vector-borne and vaccine-preventable diseases and the spillover to neighboring countries.Methods:Since October 2014, there is a paucity of official epidemiological information in Venezuela. An active search of published and unpublished data was performed. Venezuela and Latin America data were sourced from PAHO Malaria Surveillance and from Observatorio Venezolano de la Salud. Brazil and Colombian data were accessed via their respective Ministries of Health.Results:Economic and political mismanagement have precipitated a general collapse of Venezuela’s health system with hyperinflation rates above 45,000%, people impoverishment, and long-term shortages of essential medicines and medical supplies. In this context, the rapid resurgence of previously well-controlled diseases, such as vaccine-preventable (measles, diphtheria) and arthropod-borne (malaria, dengue) diseases has turned them into epidemics of unprecedented magnitudes. Between 2000-2015 Venezuela witnessed a 365% increase in malaria cases followed by a 68% increase (319,765 cases) in late 2017. The latest figures have surpassed 600,000 malaria cases with a prediction to reach 1 million by the end of 2018. Measles and diphtheria have recently re-emerged after a progressive interruption of the national immunization program, with vulnerable indigenous population being particularly affected. In response to Venezuela’s rapidly decaying situation, a massive population exodus is ongoing towards neighboring countries causing a spillover of diseases.Discussion:Action to halt the spread of vaccine-preventable diseases within Venezuela is a matter of urgency for the country and the region. Global and hemispheric health authorities should urge the Venezuelan government to allow establishing a humanitarian channel to bring relief.

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Pharmacy-based interventions to increase vaccine uptake: report of a multidisciplinary stakeholders meeting

BMC Public Health ◽

10.1186/s12889-019-8044-y ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 9

Author(s):

Fiona Ecarnot ◽

Gaetano Crepaldi ◽

Philippe Juvin ◽

John Grabenstein ◽

Giuseppe Del Giudice ◽

...

Keyword(s):

Vaccine Coverage ◽

Community Pharmacists ◽

Vaccine Uptake ◽

Main Body ◽

Potential Health ◽

Vaccine Preventable Diseases ◽

Healthcare Settings ◽

Health Authorities ◽

Adult Vaccination ◽

Coverage Rates

Abstract Background Despite the existence of efficacious vaccines, the burden of vaccine-preventable diseases remains high and the potential health benefits of paediatric, adolescent and adult vaccination are not being achieved due to suboptimal vaccine coverage rates. Main body of abstract Based on emerging evidence that pharmacy-based vaccine interventions are feasible and effective, the European Interdisciplinary Council for Ageing (EICA) brought together stakeholders from the medical and pharmacy professions, the pharmaceutical industry, patient/ageing organisations and health authorities to consider the potential for pharmacy-based interventions to increase vaccine uptake. We report here the proceedings of this 3-day meeting held in March 2018 in San Servolo island, Venice, Italy, focussing firstly on examples from countries that have introduced pharmacy-based vaccination programmes, and secondly, listing the barriers and solutions proposed by the discussion groups. Conclusions A range of barriers to vaccine uptake have been identified, affecting all target groups, and in various countries and healthcare settings. Ease of accessibility is a potentially modifiable determinant in vaccine uptake, and thus, improving the diversity of settings where vaccines can be provided to adults, for example by enabling community pharmacists to vaccinate, may increase the number of available opportunities for vaccination.

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The Value of Vaccination in Older Adults: The Why

Innovation in Aging ◽

10.1093/geroni/igaa057.2929 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 806-807

Author(s):

Philip Buck

Keyword(s):

Older Adults ◽

Time Horizon ◽

Pneumococcal Disease ◽

Population Aging ◽

Indirect Costs ◽

Health Behavior Change ◽

Vaccine Preventable Diseases ◽

Time Period ◽

The Us ◽

The Impact

Abstract The incidence of vaccine-preventable diseases remains high among older adults in the US, despite longstanding immunization recommendations, and is projected to increase as the population ages. The impact of US population aging on the burden of four vaccine-preventable diseases (influenza, pneumococcal disease, shingles, and pertussis) was modeled over a 30-year time horizon, with cumulative direct and indirect costs increasing from $378 billion over 10 years to $1.28 trillion over 30 years. Compared to current levels of vaccination coverage, increasing coverage was predicted to avert over 33 million cases of disease and greater than $96 billion in disease-associated costs, with a corresponding increase in vaccination costs of approximately $83 billion over the entire 30-year time period. Specific examples of cost-effectiveness analyses that assess the epidemiologic and economic impact of vaccination against shingles and pertussis in older adults will be discussed. Part of a symposium sponsored by the Health Behavior Change Interest Group.

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Perceptions of Treatment Burden Among Elders With Diabetes and Comorbid Alzheimer’s Disease and Related Dementias

Innovation in Aging ◽

10.1093/geroni/igaa057.882 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 276-276

Author(s):

Victoria Vaughan Dickson ◽

Halia Melnyk ◽

Rosie Ferris ◽

Joshua Chodosh ◽

Caroline Blaum

Keyword(s):

Alzheimer’S Disease ◽

Older Adults ◽

Alzheimer's Disease ◽

Qualitative Study ◽

Financial Burden ◽

Controlled Trial ◽

Healthcare Providers ◽

Patient Treatment ◽

Treatment Burden ◽

Treatment Plans

Abstract Background: An estimated 25% of older adults with diabetes (DM) may have co-occurring Alzheimer’s Disease and Related Dementias (ADRD), complicated by multiple treatment plans and providers. Assessing treatment burden has been limited to patients’ perspectives; little is known about caregiver perceptions of treatment burden despite their important role in personal care and treatment adherence. The purpose of this qualitative study was to describe caregiver perceptions of treatment burden for older adults with DM-ADRD. Methods: This qualitative study was conducted in the formative phase of “Enhanced Quality in Primary care for Elders with DM-ADRD (EQUIPED-ADRD) a pragmatic randomized controlled trial in a large, diverse healthcare system. A diverse sample of caregivers (n=15) of patients enrolled in the RCT participated in interviews about their caregiver role and perceptions of treatment burden of DM-ADRD clinical management. Qualitative data were analyzed using content analysis and themes about treatment burden were compared to domains on the Treatment Burden Questionnaire (TBQ). Results: Caregivers reported high levels of burden related to treatment plans for patients with DM-ADRD. Themes related to complexity and burden of medication management, monitoring (e.g., blood pressure, glucose monitoring), dietary and physical activity regimens, navigating healthcare providers and financial burden were reported. Caregivers also described high levels of emotional burden that was associated with patient’s cognitive decline and family functioning stress. Conclusions: Interventions to reduce treatment burden for patients and caregiver should include activating social/nursing services, respite care and care coordination that may support caregivers especially as patient treatment increases in complexity over time.

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HEALTHCARE PROVIDERS’ EXPERIENCES IN CARING FOR OLDER ADULTS WITH MULTIPLE CHRONIC CONDITIONS

Innovation in Aging ◽

10.1093/geroni/igz038.1160 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S317-S318

Author(s):

Jenny Ploeg ◽

Marie-Lee Yous ◽

Kimberly Fraser ◽

Sinéad Dufour ◽

Sharon Kaasalainen ◽

...

Keyword(s):

Older Adults ◽

Primary Care ◽

Home Care ◽

Family Caregivers ◽

Chronic Conditions ◽

Care Delivery ◽

Healthcare Providers ◽

Multiple Chronic Conditions ◽

Team Approach ◽

Personal Support

Abstract The management of multiple chronic conditions (MCC) in older adults living in the community is complex. Little is known about the experiences of interdisciplinary primary care and home providers who care for this vulnerable group. The aim of this study was to explore the experiences of healthcare providers in managing the care of community-living older adults with MCC and to highlight their recommendations for improving care delivery for this group. A qualitative interpretive description design was used. A total of 42 healthcare providers from two provinces in Canada participated in semi-structured interviews. Participants represented diverse disciplines (e.g., physicians, nurses, social workers, personal support workers) and settings (e.g., primary care and home care). Thematic analysis was used to analyze interview data. The experiences of healthcare providers managing care for older adults with MCC were organized into six major themes: (1) managing complexity associated with MCC, (2) implementing person-centred care, (3), involving and supporting family caregivers, (4) using a team approach for holistic care delivery, (5) encountering rewards and challenges in caring for older adults with MCC, and (6) recommending ways to address the challenges of the healthcare system. Healthcare providers highlighted the need for a more comprehensive integrated system of care to improve care management for older adults with MCC and their family caregivers. Specifically, they suggested increased care coordination, more comprehensive primary care visits with an interprofessional team, and increased home care support.

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Harnessing Stakeholder Perspectives and Experience to Address Nutrition Risk in Community-Dwelling Older Adults

Healthcare ◽

10.3390/healthcare9040477 ◽

2021 ◽

Vol 9 (4) ◽

pp. 477

Author(s):

Catherine B. Chan ◽

Naomi Popeski ◽

Leah Gramlich ◽

Marlis Atkins ◽

Carlota Basualdo-Hammond ◽

...

Keyword(s):

Older Adults ◽

Design Thinking ◽

Healthcare Providers ◽

Community Organizations ◽

Community Dwelling ◽

Nutrition Risk ◽

Intersectoral Cooperation ◽

Stakeholder Perspectives ◽

Patient Representatives ◽

Community Dwelling Older Adults

Community-dwelling, older adults have a high prevalence of nutrition risk but strategies to mitigate this risk are not routinely implemented. Our objective was to identify opportunities for the healthcare system and community organizations to combat nutrition risk in this population in the jurisdiction of Alberta, Canada. An intersectoral stakeholder group that included patient representatives was convened to share perspectives and experiences and to identify problems in need of solutions using a design thinking approach. Results: Two main themes emerged from the workshop: (1) lack of awareness and poor communication of the importance of nutrition risk between healthcare providers and from healthcare providers to patients and (2) the necessity to work in partnerships comprised of patients, community organizations, healthcare providers and the health system. Conclusion: Improving awareness, prevention and treatment of malnutrition in community-dwelling older adults requires intersectoral cooperation between patients, healthcare providers and community-based organizations.

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Frailty Screening Tools: Frail Detection to Primary Assessment

Elderly Health Journal ◽

10.18502/ehj.v6i1.3417 ◽

2020 ◽

Author(s):

Jonathan Aseye Nutakor ◽

Alexander Kwame Gavu

Keyword(s):

Older Adults ◽

Health Professionals ◽

Functional Decline ◽

Healthcare Providers ◽

Screening Tools ◽

Test Results ◽

Huge Number ◽

Early Screening ◽

Precise Tool ◽

Primary Assessment

Frailty is a vulnerable situation among older adults which can lead to unfavorable health outcomes such as falls, mortality, functional decline and institutionalization. The increasing number of elderly people and low rate of mortality has necessitated the need for high-quality medical services for this aging population, and this has led to a high cost of geriatric health care. There exist a huge number of screening tools to detect frailty and it is important for researchers and general practitioners (GPs) to select the appropriate and precise tool that would effectively lead to quality results. Frail individuals can be managed effectively when there is an early screening and intervention. Healthcare providers need tools that are simple and validated in order for screening and interventions to become effective. Self-reported frailty screening tools are very simple to use, not expensive and test results can be interpreted by non-health professionals. This work reviewed some of the commonly used frailty screening tools, and proposed a practical approach that would assist GPs in assessing frailty in older adults.

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A cluster of measles linked to an imported case, Finland, 2017

Eurosurveillance ◽

10.2807/1560-7917.es.2017.22.33.30595 ◽

2017 ◽

Vol 22 (33) ◽

Cited By ~ 2

Author(s):

Elina Seppälä ◽

Viktor Zöldi ◽

Sakari Vuorinen ◽

Satu Murtopuro ◽

Ulpu Elonsalo ◽

...

Keyword(s):

Public Health ◽

Vaccination Coverage ◽

Healthcare Providers ◽

International Public Health ◽

Imported Case ◽

Health Authorities ◽

Raising Awareness ◽

Public Health Authorities ◽

Close Cooperation

One imported and five secondary cases of measles were detected in Finland between June and August 2017. The measles sequences available for five laboratory-confirmed cases were identical and belonged to serotype D8. The large number of potentially exposed Finnish and foreign individuals called for close cooperation of national and international public health authorities and other stakeholders. Raising awareness among healthcare providers and ensuring universally high vaccination coverage is crucial to prevent future clusters and outbreaks.

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Communicating with the Older Adult Cancer Patient

Psycho-Oncology ◽

10.1093/med/9780190097653.003.0085 ◽

2021 ◽

pp. 678-684

Author(s):

Patricia A. Parker ◽

Smita C. Banerjee ◽

Beatriz Korc-Grodzicki

Keyword(s):

Risk Factors ◽

Older Adults ◽

Cognitive Impairment ◽

Psychological Distress ◽

Cancer Patients ◽

Older Adult ◽

Adult Population ◽

Healthcare Providers ◽

Multiple Morbidity ◽

Older Adult Population

The older adult population continues to increase. Among all known risk factors for developing cancer, the most important is growing old. Thus, caring for older adults with cancer is of increasing importance. This chapter describes important considerations involved in communicating with cancer patients including sensory impairment, cognitive impairment, multiple morbidity, polypharmacy, and psychological distress. It also describes how stereotyping and ageism affect communication with older adults with cancer. Finally, the chapter discusses ways to facilitate communication with older adult cancer patients and their families and provides an example of a training program that was created specifically to enhance communication between healthcare providers and older adult cancer patients and their families.

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