Vaccination Strategies for High-Risk Adults

The Task Force on Community Preventive Services published a report in 2005 regarding the use of population-based interventions to improve the coverage of influenza, pneumococcal polysaccharide, and hepatitis B vaccines in a variety of high-risk adult populations:

• adults aged 18-64 with medical conditions such as diabetes, heart disease, and lung disease;
• healthcare workers at high risk for occupational exposure; and
• people with high-risk behaviors for hepatitis B virus infection such as multiple sex partners or injection drug use.

Methodology

The report is based on a review of intervention studies conducted among these high risk adult populations in a variety of healthcare settings, including academic programs, outpatient clinics, hospitals, long-term care facilities, and the workplace.

Effectiveness of the interventions was measured by changes in vaccination coverage rates for influenza, pneumococcal polysaccharide, and hepatitis B vaccination.

Key Findings

Reviews of qualifying studies identified strong evidence of effectiveness of provider reminder systems, when implemented alone, in increasing targeted vaccination coverage.

While insufficient evidence was found to determine the effectiveness of all other interventions when implemented alone, the Task Force identified evidence that certain combinations of interventions have improved vaccination coverage.

Therefore, the Task Force recommends a combination of interventions that include selected interventions from two or three categories of interventions (i.e., increasing community demand for vaccinations, enhancing access to vaccination services, and provider- or system-based interventions).