October 2007 NVAC Meeting Minutes
insurance. Hispanics were much more likely than Blacks and Whites to be without health insurance.
Dr. Adele E. Young asked why people did not trust the influenza vaccine and what specific side effects of the vaccine worried them. Dr. Ahmed explained that members of the focus group stated—either from personal experience or from hearing from others—that they still got the flu after getting the vaccine. He also observed that compared with other vaccines, the influenza vaccine seems to have the most problems.
Dr. Hinman explained that one reason people may not trust the influenza vaccine is because there are many illnesses that are called influenza—or the flu—that are really not the flu. He also mentioned being surprised by the statistic that 44 percent of physicians said they already immunized all eligible patients. He believes that this suggests that physicians do not realize who their eligible patients are. He believes that immunization registries can help identify eligible patients but that physicians overestimate how well they are doing in terms of vaccination coverage.
Discussion returned to the question of exactly what side effects patients fear when getting the flu vaccine. Dr. Ahmed responded that patients were more concerned about minor illnesses and not major problems such as Guillain-Barré Syndrome (GBS).
Dr. Sharon G. Humiston asked for information on the costs, in 2007 dollars, of administering, purchasing, and storing the influenza vaccine. One of Dr. Ahmed’s colleagues responded that no data were available in terms of 2007 dollars. However, when using old data with much lower reimbursement rates, giving the flu vaccine was a losing proposition, except in the largest practices. She concluded by saying that for 2007, it is probably a break-even proposition.
Dr. Schuchat stated that in her opinion, the most telling statistic was the survey of providers in which a very large proportion said that with greater financing, they would still not offer the influenza vaccine. Dr. Almquist noted that adult practices are not generally set up for a role as immunization providers.
Barriers to Adult Immunization: Findings From Recent Consumer and Healthcare Provider Surveys—Dr. David R. Johnson
Dr. David R. Johnson (sanofi pasteur) began the presentation by explaining that sanofi pasteur commissioned Adelphi Research by Design to conduct consumer and healthcare professional surveys to get more information about barriers to adult immunization. The objectives of the surveys were to provide a thorough assessment of the reasons U.S. adults do not receive recommended vaccines and to provide recommendations to increase vaccination rates. The surveys included questions about vaccinations in general and, specifically, about three adult vaccines: Influenza, pneumococcal, and Td. The surveys were conducted with just over 2,000 consumers, over the telephone, during September and October of 2006. An additional survey focused on 200 healthcare providers, including 100 primary care physicians and a mix of 100 physician assistants, nurse practitioners, and registered nurses in primary care practices.
One key finding of the survey was that provider recommendations are a critical factor in consumer vaccination decisions; however, most consumers never talk to their providers about vaccines. Another key finding was that healthcare providers’ perceptions of why consumers forgo vaccinations do not always accurately reflect reasons cited by the consumers themselves for forgoing vaccination.
The study also found that healthcare professionals (HCP) have gaps in their knowledge about vaccinations. For example, between 40 and 44 percent of HCPs do not use CDC’s immunization schedule. Also, a small number of providers believed that individuals with mild to moderate illnesses