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A review of the key factors to improve adult immunization coverage rates: What can the clinician do?

机译：审查提高成人免疫覆盖率的关键因素：临床医生可以吗？

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Adult immunization coverage rates remain low in the United States and internationally, despite obvious benefits to vaccinating and maintaining a well-vaccinated adult population. Broad policy changes are required to identify and address gaps in financing, in immunization infrastructure, and patient and provider awareness and knowledge to improve the protection of our adult and aging population from vaccine-preventable diseases. There is good evidence that efforts are now underway both within the United States and across the world to advance these policy changes. There are successful interventions that have been demonstrated to improve rates in the pediatric population that must be translated into the adult patient population to meet the critical gaps that remain at the interface of the delivery of vaccinations to adults. Improvements in overall policy will only increase adult immunization coverage rates if interventions are adapted and implemented for adult patients. Often, these same interventions will be applicable to adolescent patients as well. These interventions have been reviewed by the United States Preventive Services Task Force and recommended interventions fall into three categories: (1) Enhancing Patient Access to Vaccination; (2) Improving community/patient demand; and (3) Provider- and healthcare system-directed interventions. Specific interventions that have been demonstrated successful for the adult population include interventions such as reducing patient out-of-pocket costs for vaccinations, patient or family incentive rewards, and implementation of quality measures and quality improvement interventions. Addressing the poor performance in adult immunizations requires approaches predicated on not repeating previous efforts and will require innovative thinking to integrate multiple interventions that have been successful separately, into a holistic approach to support and automate immunization assessment, recommendation, and administration. This can then lead to increased valuation of adult and adolescent immunizations within the priorities of a healthcare system, and improvements in clinic efficiency within a practice.
机译：尽管疫苗接种和维持疫苗接种疫苗的成年人口，但成年免疫覆盖率仍然很低。需要广泛的政策变更来识别和解决融资中的差距，免疫基础设施和患者和提供者意识和知识，以改善从疫苗可预防的疾病的保护和老化人口的保护。有良好的证据表明，在美国和世界各地的努力都在进行努力推进这些政策的变化。有成功的干预措施已经证明，提高了儿科人群中必须转化为成年患者人口的税率，以满足留在向成年人提供疫苗接种界面的关键差距。如果干预适用和实施成人患者，整体政策的改进只会增加成人免疫覆盖率。通常，这些相同的干预措施也适用于青少年患者。这些干预措施已被美国预防性服务工作队审查，建议的干预措施分为三类：（1）增强患者接种疫苗接种; （2）改善社区/患者需求; （3）提供者和医疗保健系统导向干预措施。已经证明成年人口成功的具体干预包括干预措施，例如减少患者的患者的疫苗接种，患者或家庭激励奖励，以及实施质量措施和质量改进干预措施。解决成年免疫的不良表现需要预测的方法不再重复以前的努力，并需要创新的思考，以整合一份已经成功的多种干预措施，以实现支持和自动化免疫评估，建议和管理的整体方法。然后，这可以导致成人和青少年免疫的估值在医疗保健系统的优先事项内，以及在实践中的临床效率的改进。

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