Vaccination Barriers for Adults

The growth of childhood vaccination in India has been increased over the past two decades as >25% of deaths due to infections are prevented with the help of vaccines. Vaccination is also recommended for adults where adult vaccination is mostly ignored in India. In India, childhood vaccination is considered the main priority, WHO has also issued guidelines for childhood vaccination. Generally, adults have less susceptible to traditional infectious agents but the probability of exposure to the infectious agents has increased. SO the problem of adult immunization should be considered. Vaccine-preventable diseases (VPDs) in adults are more neglected. There are many reasons for the causes of the VPDs in adults. These can be prevented by immunization among adults. Each country should provide a proper guideline for adult vaccination. When it comes to India, our country doesn’t have proper guidelines for Adult immunization. As to decrease the morbidity and mortality in the life of a person the vaccine uptake for the immunization must be ensured. This article mainly focuses on the vaccine-preventable disease in India with the role of adult immunizations and the steps to ensure the betterment of the vaccine uptake among the adults.

Improving Adult Vaccination Status in the United States

Adult immunization practices leave much to be desired. Misinformation has increased mistrust. As a result, Latino and African American populations have low rates of annual flu vaccinations and, during the COVID-19 pandemic, lag behind for COVID-19 vaccination. Historically, healthcare staff have failed to adhere to adult immunization guidelines contributing to patient infections. Healthcare staff, both clinical and non-clinical, must lead by example by making “prevention primary”. Most adults may not realize they need immunizations. We recommend the following steps to increase immunization uptake: Make adult immunization a standard of patient care as we do for children. Assess immunization status at every clinical opportunity. Strongly recommend vaccinations needed. Administer needed vaccinations, multiple if warranted. Document vaccines received by your patient. Participate in your state’s immunization registry and work with community organizations that can help make adult immunization the norm.

1385Hesitancy for Adult Vaccination -A New Paradigm for Research in India

Background Adult immunization has recently emerged as an area of emphasis in research and policy. Increasing life expectancy, outbreaks like COVID-19, and the endemic nature of diseases like dengue, malaria have underscored its importance. Therefore, this study was carried out with the aim to assess hesitancy and factors influencing the uptake of vaccines in adults. Methods An online cross-sectional study was conducted among adults (age more than 20 years). Data collection was done by convenience sampling in January 2021. Information on awareness and perceptions regarding adult vaccination and immunization status of participants was collected. Data analysis was done using SPSS version 21. Results A total of 461 adults responded to the survey. Among those who had never received any vaccine in adulthood (n = 158), the reasons were lack of recommendation by healthcare providers (38.6%), lack of knowledge of vaccines (15.8%) and fear of adverse effects following vaccination (7.6%). Hesitancy for vaccines among those who were informed by healthcare workers was as follows: shingles (97.8%), human papillomavirus (92.1%), pneumococcal (91.1%), influenza (79.7%), varicella (79.4%) and tetanus (57.6%). Conclusions Reduced vaccine uptake due to vaccine hesitancy in adulthood is a major health concern. Hesitancy was highest for the shingles vaccine and least for the tetanus vaccine. Key messages Coverage of adult vaccination can be improved by formulating national guidelines and encouraging healthcare providers to raise awareness. In-depth qualitative studies are needed to understand the perception of adults towards vaccination.

Global Landscape Review of Serotype-Specific Invasive Pneumococcal Disease Surveillance among Countries Using PCV10/13: The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) Project

Serotype-specific surveillance for invasive pneumococcal disease (IPD) is essential for assessing the impact of 10- and 13-valent pneumococcal conjugate vaccines (PCV10/13). The Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project aimed to evaluate the global evidence to estimate the impact of PCV10/13 by age, product, schedule, and syndrome. Here we systematically characterize and summarize the global landscape of routine serotype-specific IPD surveillance in PCV10/13-using countries and describe the subset that are included in PSERENADE. Of 138 countries using PCV10/13 as of 2018, we identified 109 with IPD surveillance systems, 76 of which met PSERENADE data collection eligibility criteria. PSERENADE received data from most (n = 63, 82.9%), yielding 240,639 post-PCV10/13 introduction IPD cases. Pediatric and adult surveillance was represented from all geographic regions but was limited from lower income and high-burden countries. In PSERENADE, 18 sites evaluated PCV10, 42 PCV13, and 17 both; 17 sites used a 3 + 0 schedule, 38 used 2 + 1, 13 used 3 + 1, and 9 used mixed schedules. With such a sizeable and generally representative dataset, PSERENADE will be able to conduct robust analyses to estimate PCV impact and inform policy at national and global levels regarding adult immunization, schedule, and product choice, including for higher valency PCVs on the horizon.

Applying the AFIX Quality Improvement Model to Increase Adult Immunization in Wisconsin

Objectives Assessment, Feedback, Incentives, and eXchange (AFIX) is a quality improvement model used to increase childhood and adolescent immunization rates in the United States. We evaluated implementation of a similar quality improvement model to boost adult immunization rates. Methods During November 2016 through May 2017, adult immunization outreach specialists conducted 124 in-person visits to clinics in Wisconsin that immunize adults, submit immunization information to the Wisconsin Immunization Registry (WIR), and agreed to participate in adult AFIX. Outreach specialists ran immunization assessment reports using the WIR and showed a paper copy of the report during the visit. Health care providers were encouraged to implement at least 1 of 18 strategies (eg, reminder-and-recall intervention, giving adult immunization resources to patients) to increase adult immunization rates. Outreach specialists conducted follow-up with health care providers at 3, 6, and 9-18 months after the initial visit to encourage strategy implementation. We compared AFIX sites with control clinics on practice type, geographic location, and clinic size. Results Clinics that participated in adult AFIX had a significantly larger increase in median adult immunization rates for completion of the human papillomavirus vaccine series at the 9- to 18-month follow-up than control clinics did (10.4% vs 7.7%; P = .02). The median immunization rate for 13-valent pneumococcal conjugate vaccine/23-valent pneumococcal polysaccharide vaccine completed in series was higher, but not significantly so, among adult AFIX clinics than among control clinics (12.6% vs 10.7%; P = .18). Conclusions Adult AFIX resulted in increased awareness about adult immunization recommendations and may be a useful tool for increasing adult immunization rates.