Adult vaccination coverage in the United States: A database analysis and literature review of improvement strategies

Amanda L Eiden · Louise Hartley · Diana Garbinsky · Cassondra Saande · Meghan Hufstader Gabriel · Mark A Price +1 more

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Vaccine Coverage and Hesitancy Health Promotion and Cardiovascular Prevention Intramuscular injections and effects

Abstract

Despite vaccines being instrumental in reducing vaccine-preventable disease, adult vaccination rates in the United States (US) are below optimal levels. To better understand factors affecting vaccination rates, we analyzed trends in adult vaccination coverage using data from the Behavioral Risk Factor Surveillance System (BRFSS) and conducted a targeted literature review (TLR) on interventions to improve adult vaccination rates in the US. Both the BRFSS analysis and the TLR focused on influenza; pneumococcal disease; tetanus and diphtheria or tetanus, diphtheria, and acellular pertussis; herpes zoster; and human papillomavirus vaccination for US adults aged 18-64 years. The TLR additionally included hepatitis A and hepatitis B vaccination. Vaccination coverage rates (VCRs) and changes in VCRs were calculated using the 2011-2019 BRFSS survey data. For the TLR, the MEDLINE and MEDLINE In-Process databases were searched for articles on vaccination interventions published between January 2015 and June 2021. The BRFSS analysis showed that changes in VCRs were generally modest and positive for most states over the study period. The TLR included 32 articles that met the eligibility criteria; intervention strategies that improved adult vaccination outcomes incorporated an educational component, vaccination reminders or reinforcement at the point of care, or authorized non-clinician members of the healthcare team to vaccinate. Furthermore, interventions combining more than one approach appeared to enhance effectiveness. The strategies identified in this TLR will be valuable for policymakers and stakeholders to inform the development and implementation of evidence-based policies and practices to improve adult vaccination coverage.

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2018PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation 2020Impact of Vaccines; Health, Economic and Social Perspectives 2017Surveillance of Vaccination Coverage among Adult Populations — United States, 2015 2021Surveillance of Vaccination Coverage Among Adult Populations —United States, 2018 2016Community pharmacies as sites of adult vaccination: A systematic review 2016Immunization in the United States: Recommendations, Barriers, and Measures to Improve Compliance: Part 1: Childhood Vaccinations.2018Association of provider recommendation and offer and influenza vaccination among adults aged ≥18 years – United States 2015Adult vaccination: Now is the time to realize an unfulfilled potential

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