According to the CDC, the gap between immunization rates in minority and white populations has been narrowed but disparities still exist among many racial, ethnic, and underserved populations, especially among adults. The National Center for Health Statistics estimated that in 1999 approximately 90 percent of all influenza and pneumonia related deaths occurred in individuals aged 65 and older. Further, older Hispanic and African-American adults are much less likely to be vaccinated against influenza and pneumococcal disease than their white counterparts. These findings prompted the federal Department of Health and Human Services (HHS) to set a goal of increasing influenza immunizations to 60 percent among all adults aged 65 years and older by 2010.
The Adult Immunization: Shots to Save Lives report published by the Trust for America's Health, the Infectious Diseases Society of America, and the Robert Wood Johnson Foundation found that millions of U.S. adults go without vaccinations each year leading to $10 billion in preventable health costs, thousands of preventable illnesses, and 40,000 - 50,000 preventable deaths.
Michigan currently has an overall immunization rate for adults 65 and older of 65.8%. Michigan's proposed legislation seeks to enhance this percentage by reducing barriers to adult immunizations and taking advantage of opportunities to immunize adults during visits in hospitals as recommended by the HHS plan to improve adult immunizations. New requirements for hospitals would include: a strategic plan for managing its supply of the influenza vaccine; procedures for identifying individuals at least 65 years old and admitted to the hospital; procedures for offering influenza immunizations to people at least 65 years old; procedures for ensuring an individual offered the vaccine received information regarding its risks and benefits; a policy including an assessment for medical contraindications; and a system capable of documenting the influenza vaccination administration, medical contraindications, patient refusals, and any post-vaccination adverse events.
Though these bills are supported by the Department of Community Health and the Michigan Health & Hospital Association, they are unlikely to pass. Michigan has already reached the 60% goal for influenza immunizations among all adults aged 65 years and older established by HHC. Given that accomplishment, the legislature may be hard pressed to justify imposing on hospitals (14 in Michigan) additional costs associated with the development and implementation of a vaccination administration system.