Although the barriers for our children and adults to get immunized differ, most would agree that thousands of lives could be saved each year if we can increase the number of adults who receive routine immunizations. One third of adults ages 65 years and older did not receive the pneumonia vaccine. Annually 36,000 Americans die of the flu and 5,000 die of pneumonia.
That is the health care system is not set up to deliver preventative services and many adults don’t have regular check-ups. Many physicians who only care for adults are not accustomed to providing vaccines in their office. Primary care physicians are more likely to immunize their patients versus other providers yet many adults only receive medical care from specialists.
The key barriers for children immunizations are related to the time it takes for insurance companies to cover immunizations once it has been recommended by the Centers for Disease Control. At times, Vaccines for Children program will need 6 month after a vaccine is covered by the CDC before it is available at the physician office. In addition, private insurers will often take longer and not all insurance companies will come on board at the same time, which may cause confusion for physicians.
Physicians may also hold back from giving a new vaccine because they don’t know if a particular insurer is covering the vaccine in question. And at time vaccines are administered and not get covered by insurance or when they are covered the insurance company will cover a cheaper vaccine. Typically, physicians must negotiate and enter into collaborative agreements with manufacturers in order to obtain vaccines at competitive prices just so that the vaccines they administer can be break even with insurance payments.
As part of your care you may encourage your primary care provider’s office to review your immunization history. Patients may also schedule physicals and be informed regarding their insurer’s coverage for physicals and immunizations.