CS HCVG15-ADU-130 07/26/2016 

Overview

A Series on Standards for 

Adult Immunization Practice

In 2014, the National Vaccine Advisory Committee updated the 

Standards for Adult Immunization Practice to reflect the critical 

need for ALL healthcare professionals—whether they provide 

immunization services or not—to take steps to ensure that adult 

patients get the vaccines they need. 

Patients trust you to give them the best 

advice on how to protect their health.

Make adult vaccination a standard of care

in your practice. 

Why should adult immunization 

be a priority for your practice?

1. Your patients are probably not getting the vaccines they 

need. Even though most private insurance plans cover the 

cost of recommended vaccines, adult vaccination rates 

in the United States are extremely low. Each year, tens of 

thousands of adults needlessly suffer, are hospitalized, and 

even die as a result of diseases that could be prevented 

by vaccines. 

2. Your patients are likely not aware that they need vaccines. 

Although adults do believe immunization is important, 

many don’t know which vaccines are recommended for 

them throughout their lives. Many also report not 

receiving vaccine recommendations from their 

healthcare professional. 

3. You play a critical role in ensuring that your patients are 

fully immunized. Clinicians are the most valued and 

trusted source of health information for adults. Your 

patients rely on you to inform them about the vaccines 

they need. Research shows that a recommendation from 

their healthcare professional is the top predictor of patients 

getting vaccinated.

2014 U.S. Adult Vaccination Rates

Only 20% of adults 19 years or older had received 

Tdap vaccination. More than 18,000 cases of 

whooping cough were provisionally reported in 

2015. About five in 100 adults with pertussis are 

hospitalized and others may have complications, 

which could include pneumonia. Adults can also 

spread pertussis to infants, who are at most risk for 

severe illness and death from this disease.

Only 28% of adults 60 years or older had 

received zoster (shingles) vaccination. Nearly 

1 million Americans experience the condition each 

year, and about half of all cases occur in adults 60 

years or older. Older adults are also most likely to 

experience severe pain from the disease and have 

postherpetic neuralgia.

Only 20% of adults 19 to 64 years at high risk 

had received pneumococcal vaccination. While 

coverage among adults 65 years or older is better, 

there are still many adults left unprotected. About 

67 million adults at increased risk for pneumococcal 

disease remain unvaccinated.

Only 44% of adults 18 years or older had 

received flu vaccination during the 2014-2015 

flu season. On average, more than 200,000 people 

are hospitalized each year from influenza-related 

complications. 

Sources: NHIS 2013, NHIS 2014 (MMWR 2016; 64(4)),

BRFSS 2014-2015 (www.cdc.gov/flu/fluvaxview)

Information Series for Healthcare Professionals

www.cdc.gov/vaccines/adultstandards

DON’T WAIT.

VACCINATE! U.S. Department of 

Health and Human Services 

Centers for Disease 

Control and Prevention 
Summary of 2014 Standards for Adult Immunization Practice

1. ASSESS immunization status of all your patients at every clinical encounter. 

• Stay informed about the latest CDC recommendations

for immunization of adults. 

• Implement protocols in your office to ensure that patients’ 

vaccine needs are routinely reviewed and patients get reminders 

about vaccines they need. 

2. Strongly RECOMMEND vaccines that patients need.

• Address patient questions and concerns in clear and 

understandable language. 

• Explain the benefits of getting vaccinated and potential costs

of getting the diseases they protect against.

• Highlight positive experiences with vaccination (personal 

or in your practice) to reinforce the benefits and strengthen 

confidence in vaccination.

3. ADMINISTER needed vaccines or REFER patients to a 

vaccinating provider.

• For vaccines that you stock, make vaccination services 

as convenient as possible for your patients.

• For vaccines that you don’t stock, refer patients to providers

in the area that offer vaccination services. 

4. DOCUMENT vaccines received by your patients.

• Participate in your state’s immunization registry to help 

your office, your patient, and your patients’ other providers 

know which vaccines your patients have had. 

• Follow up to confirm that patients received recommended vaccines

that you referred them to get from other immunization providers.

All healthcare professionals should also ensure that 

they, and their practice staff, are up-to-date on their OWN 

vaccinations per ACIP recommendations and consistent 

with professional guidelines. 

www.cdc.gov/vaccines/adults/rec-vac/hcw.html

for more information

Proven strategies

to increase 

vaccination rates

In a recent survey of U.S. primary 

care physicians, only 29% of 

general internists and 32% of 

family physicians report assessing 

vaccination status at every visit. 

The CDC recommends the following 

evidence-based strategies for 

reducing missed opportunities and 

improving vaccination rates:

Standing orders authorize 

nurses, pharmacists, and other 

healthcare professionals to assess a 

patient’s immunization status and 

administer vaccinations according 

to an approved protocol without the 

need for examination or direct order 

from the attending physician. 

Provider reminder interventions, 

such as notes in client charts and 

alerts in electronic medical records, 

inform providers and their staff 

that individual patients are due for 

specific vaccines.

Immunization Information Systems 

(IIS) support patient vaccination 

status assessment, reminder and 

recall interventions, and provider 

assessment and feedback.

www.TheCommunityGuide.org/vaccines

For more information on the 2014 Standards and 

resources for improving adult immunization practice, 

visit: www.cdc.gov/vaccines/adultstandards

Last updated May, 2016