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AAP offers recommendations to increase vaccination coverage
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Pediatricians and other child health care professionals should collaborate with local, state and national governments to overcome major barriers to boosting immunization rates, including vaccine shortages, high costs and an ardent antivaccination movement, according to a policy statement issued by the American Academy of Pediatrics.
The document underscores the importance of timely vaccination for all children, but its writers note that problems with vaccine supply may stand in the way of achieving this goal. “Over the past 10 years, shortages of hepatavalent pneumococcal conjugate, Hib, HBV, influenza, hepatitis A virus, varicella zoster, and meningococcal conjugate vaccines have led to missed opportunities to immunize and have placed a large administrative burden on the delivery system,” they wrote.
The AAP guidelines address this issue by recommending that pediatricians call upon manufacturers and state and federal governments to stock sufficient amounts of vaccines. In the event of shortages, vaccine providers should receive ample notice, and plans should be in place to expedite equitable distribution of products until the shortage has ended.
The writers also urge physicians to use immunization information systems, electronic medical records and office charts to create an efficient reminder/recall system that will help ensure that children remain up-to-date on their immunizations.
Rising vaccine costs also present a challenge for physicians and parents. The price for immunizing children has increased sixfold since 1995, according to the AAP, and current acquisition costs have escalated to more than $900 for boys and more than $1,200 for girls. Although public or private sources boast funding for immunization, payment levels do not usually provide adequate reimbursement for buying, storing and administering vaccines.
To counter this problem, the AAP encourages pediatricians and other health care professionals to call for a public-private partnership in the manufacture and distribution of vaccines. The writers note that vaccine purchasers would have greater knowledge about acquisition costs and can therefore weigh potential financial losses before buying and stocking certain vaccines. Furthermore, as new or combination vaccines become available, providers can push for more reasonable prices and adjusted payments.
The AAP also recommends that insurance companies eliminate deductibles and copays for vaccines to remove the financial burden placed on parents. The writing group also suggests that pediatricians investigate and refer parents to alternative venues, such as school-based health care clinics or childcare centers, where vaccination may cost less.
The policy statement also tackles the issue of how the antivaccination sentiment permeating the media is another major obstacle. “Pediatricians find themselves spending large amounts of time convincing frightened parents to follow published evidence-based recommendations for vaccine administration, thereby reducing time available for other important components of anticipatory guidance,” they said.
In response to this problem, AAP members wrote that ongoing education and quality-improvement programs for pediatricians and health care professionals will improve the information that they disseminate to parents and help them to better communicate the benefits of vaccination. The writers also suggest that a large public relations campaign could make the public aware of the misinformation being spread by celebrities and others who support the antivaccination movement. – by Melissa Foster
AAP. Pediatrics. 2010;125:1295-1304.
The statement is extremely naive. It calls for increase of supply while also calling for lower costs and public-private partnerships. I also would like to eat more while losing weight and paying less. If you could also add in guaranteed happiness and long life, I guess that would all be fine. What is really needed is aggressive lobbying to reimburse pediatricians for vaccine purchase and storage by insurers and to cover first dollar cost without deductible. Diluting this message with the others does not move us forward. Also, the proposed means of addressing the antivaccine lobby is ludicrous.
– Steven B. Black, MD
Infectious
Diseases in Children Editorial Board