Information, clinician advice may be key to boosting vaccines in older people

Hawaii Senate / Flickr cc

Only 15% of US adults aged 50 and older and 25% of those 65 and older are up to date on recommended vaccinations against infectious diseases such as flu, respiratory syncytial virus (RSV), and pneumococcal disease, but a recent study suggests that giving patients information before their appointment and a clear endorsement from their healthcare provider (HCP) could increase uptake in these age-groups.

For the study, published in Open Forum Infectious Diseases, a team led by a University of Virginia (UVA) researcher and PRIME Education surveyed patients and HCPs at six primary care/geriatric clinics before and after a patient-HCP collaborative learning session and use of a customized shared decision-making (SDM) tool.

HCPs also participated in audit-feedback sessions to create action plans to improve vaccination rates at their clinic. The study was supported by drug manufacturer GSK.

HCP recommendation top motivator

Of the 72 patients who used the SDM tool and completed both surveys, only 40% reported being current with all recommended vaccines before the intervention, 76% had not received a dose of shingles vaccine, and 65% had not regularly discussed barriers to vaccination with their HCP.

The vaccination schedule for older adults, like for pediatric patients, can be confusing—to know what is needed and when.

Laurie Archbald-Pannone, MD

But after the intervention, 81% of patients said they talked about their vaccination concerns with their HCP more or much more than in previous visits and were more willing to get vaccinated (72% before vs 89% after). Among the 14 HCPs who completed follow-up surveys, 57% said vaccine coverage rose after learning sessions and SDM, with the top strategies being SDM (50%) and patient-HCP vaccine discussions (43%).

The most commonly cited barriers to vaccination in the 133 patients who participated in the learning sessions were knowing which vaccinations were needed (57%) and paying for them (54%). After the learning session, patients’ knowledge about RSV-related hospitalization risk climbed from 40% to 65%.

After the intervention, 59% of 123 patients said they planned to receive the recommended vaccines. Most patients (67%) listed a clear recommendation from an HCP as the top motivator to get vaccinated, but only 33% of 24 HCPs agreed that such a recommendation is important.

"The vaccination schedule for older adults, like for pediatric patients, can be confusing—to know what is needed and when," lead author Laurie Archbald-Pannone, MD, of UVA, said in a university news release. "Patients in the study reported that a clear recommendation from their healthcare provider was most impactful in getting them vaccinated."