Immunizations in adulthood.
ABSTRACT Vaccine preventable diseases continue to be a sizable burden to adults in the United States. Despite availability of safe and effective vaccines, immunization rates remain low. While various patient, clinician, and system factors can be barriers to adult vaccination, physicians recommendations to their patients to receive the vaccinations for which they are indicated is strongly related to a patient's receipt of these immunizations.
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ABSTRACT: The American College of Physicians (ACP) developed a quality improvement (QI) program to address deficiencies in immunization rates, primarily for influenza, and determine the program's impact on adult immunization. An interventional study using a pre-post design. Three cohorts of physician practices were invited from a random sample of 2000 to attend 1-day training sessions in 2004, 2005, and 2006 in Philadelphia, Pennsylvania. Participants performed data abstractions and developed QI plans. Baseline data were compared with follow-up. Fifty-five practices received training, 39 practices provided baseline data, and 11 practices provided follow-up data, reporting on 4208 patients. Baseline rates for influenza were 51% for cohort 1, 42% for cohort 2, and 59% for cohort 3. Follow-up data collection is ongoing. Rates increased for patients with private insurance and patients aged 50 to 64 years, suggesting that many providers attending the training were unaware of the need to vaccinate these patients.American Journal of Medical Quality 01/2008; 23(3):176-83. · 1.47 Impact Factor
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ABSTRACT: Older age is an important factor in preparing travelers owing not only to physiologic changes and the increased probability of underlying medical conditions and prescription medications but also to immune status with regard to naturally acquired immunity versus immunization for vaccine-preventable diseases. Cardiovascular events (including myocardial infarctions and cerebrovascular accidents) account for most deaths abroad, followed by injuries. To plan for healthy travel, international travelers should be advised to seek care at least 4 to 6 weeks before departure. Travel medicine is a dynamic field because conditions worldwide are subject to rapid change. Clinicians must maintain a current base of knowledge if they will be regularly advising travelers or must set a threshold for referral to a travel medicine specialist.Clinics in Geriatric Medicine 09/2007; 23(3):687-713, ix. · 3.14 Impact Factor
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ABSTRACT: Adult immunizations have dramatically improved the health of many Americans. In the United States, researchers have documented disparities in the utilization of adult vaccinations between whites and racial and ethnic minority populations. This article examines racial and ethnic attitudes regarding recommended adult vaccinations. Four adult focus groups (N=22) were conducted in community churches in San Francisco, CA. Participants were either age-appropriate or had clinical indications to receive a strong recommendation for influenza and pneumococcal immunizations but had not been routinely immunized against influenza and had never been vaccinated against pneumococcal disease. Content analysis was used to analyze narrative data and identify emerging themes. Participants reported that they lacked information about the benefits or potential side effects of influenza and pneumococcal vaccinations and that their physicians were not routinely informing them of, or recommending, these vaccinations. Meanwhile, most participants expressed a willingness to be vaccinated against pneumococcal infection and influenza. All focus group participants felt that community churches were a potential venue for delivery of adult vaccines. Many adult racial and ethnic minorities have basic information regarding the influenza vaccine but lack sufficient information regarding the benefits of pneumococcal vaccinations. Physicians should provide information regarding adult vaccinations to all patients. On-site vaccination and vaccine education programs in community churches may be successful in increasing the utilization of adult vaccinations in unvaccinated church populations.Journal of the National Medical Association 12/2004; 96(11):1455-61. · 0.91 Impact Factor