Immunization Update
Cristian Rodriquez, PharmD
What are the specific reasons for patients not receiving necessary vaccinations? As vaccine hesitancy grows, a study published January 29, 2025, in Open Forum Infectious Diseases took a deep dive into those reasons—specifically for older adults—as researchers sought to find a solution to the problem.
Only about 15% of adults aged 50 and older and 25% of adults aged 65 and older report being up to date on their recommended vaccines, according to CDC.
Researchers found that more often than not, the hurdle to vaccination for older adult patients is lack of awareness or confusion about their recommended regimen.
“The vaccine schedule for older adults is complicated and has changed in the past few years,” said Laurie Archbald-Pannone, MD, from the University of Virginia School of Medicine and one of the authors of the study. “It’s hard for clinicians and our patients to keep up with the recommendations. Knowing the recommended vaccine schedule and how to explain their importance to our patients is at the core of our role in caring for older adults.”
Additionally, most patients (67%) in the study group listed a strong recommendation from a health care provider as the best motivator to getting vaccinated. However, only 33% of providers surveyed perceived that it would be important.
The data
Researchers from PRIME Education, a medical education and research company, conducted the study from August 2023 to January 2024 in six primary care/geriatric clinics. They found the following hurdles for patients receiving recommended vaccinations: knowing which vaccinations were needed (57%); paying for vaccinations (54%); keeping track of vaccines and “when I am due for the next one?” (36%); and concerns about adverse effects (30%).
The researchers then took their study a step further and provided patients with either a two-page vaccination discussion guide (apha.us/VaccineDiscussion) or an invitation to attend a 1-hour education session with providers after their visit. The two-page document was developed by PRIME Education and was designed to help guide patients in a conversation with their providers about vaccines.
In a survey that followed these interventions, the percentage of patients who said they wanted to receive a vaccine increased to 79% after using the vaccination guide. Additionally, 79% of patients reported that they discussed more about vaccines with their provider than they had in prior visits. Compared to their confidence beforehand, 72% of patients felt more confident in making decisions about recommended vaccines following the education session.
Why does this matter?
As a vaccination provider, pharmacists can recommend vaccinations to their older adult patients. A study published in December 2024 in JAPhA found very similar results from that of the study done by PRIME Education.
The JAPhA researchers sought to uncover and quantify factors contributing to vaccine hesitancy by exploring the nature of patient–pharmacist conversations about pneumococcal vaccine. Pharmacies were trained on how to enhance pharmacists’ knowledge, skills, and abilities in promoting pneumococcal vaccination through improved patient–pharmacist communications. They found that the education changed the reasons for refusing vaccines, alluding to the importance and impact patient–pharmacist conversations have on the patients themselves and their decision to get vaccinated.
For more information on vaccines in older adults and to find the current recommendations, visit the CDC website at www.cdc.gov/vaccines/hcp/imz-schedules/adult-age.html. ■