CS HCVG15-ADU-131 07/26/2016 

Vaccine Needs Assessment

A Series on Standards for Adult Immunization Practice 

Assessment is the critical first step in ensuring that your adult 

patients get the vaccines they need for protection against 

serious vaccine-preventable diseases. 

As a standard of care—whether you provide vaccines 

or not—you should assess your patients’ immunization 

status at every clinical encounter and strongly recommend 

vaccines that they need. 

Assessing your patients’ vaccination status at every 

clinical encounter will decrease missed opportunities 

to vaccinate.1, 2, 3

• Many adults do not schedule annual check-ups or come in for preventive 

services, therefore it is critical to assess vaccine status whenever they do 

come in for a visit.

• Some vaccines are indicated for adults based on factors other than age, 

making it important to assess regularly whether your patients have had 

lifestyle, health, or occupational changes that may prompt the need for 

additional vaccines.

• Vaccine recommendations for adults change over time, and your patients 

may not be up to date with the latest recommendations.

There are simple ways to implement routine vaccine 

assessment into your office patient flow. 

• Give patients a vaccine assessment form at check-in. 

• Include standing orders or protocols for nursing staff to assess and 

administer needed vaccines.

• Integrate vaccine prompts into electronic medical records.

See back for more tips and resources.

Routinely assessing patient vaccination status will 

make a difference. 

Adults think immunization is important, but most don’t know which 

vaccines they need throughout their lives. Research indicates that your 

recommendation is the strongest predictor of whether patients get 

vaccinated.4 Implement policies to ensure your patients’ vaccination 

needs are routinely reviewed. 

For information on insurance coverage of vaccines 

for adults, visit: www.cdc.gov/vaccines/hcp/adults 

U.S. vaccination 

rates for adults are 

extremely low.

For example:

• Only 20% of adults 19 years 

or older have received

Tdap vaccination.

• Only 28% of adults 60 years 

or older have received zoster 

(shingles) vaccination.

• Only 20% of adults 19 to 64 

years old, at high risk, have 

received pneumococcal 

vaccination.

• Only 44% of adults 18 years 

or older had received flu 

vaccination during the 

2014–2015 flu season.

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

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

For resources and tips on vaccine 

recommendation, administration, 

referral, and documentation, visit:

www.cdc.gov/vaccines/adultstandards

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 
Tips for Improving Vaccine Assessment in Your Practice 

• Implement standing orders or protocols. Routinely incorporate vaccine assessment and vaccination 

the same way you incorporate measuring weight and blood pressure during patient office visits.

Examples: www.immunize.org/standing-orders 

• Give your patients a vaccine questionnaire to complete at check-in. This can help 

identify vaccines your patients may need based on factors such as upcoming travel or changes in medical conditions.

Example: www.cdc.gov/vaccines/hcp/adults/downloads/patient-intake-form.pdf

• Use reminders to help your practice 

stay on top of needed vaccines that are 

due soon or are overdue. These reminders 

can be generated by a computer system (Electronic Health 

Record) or immunization registries, or you can make a 

note of needed vaccines on a patient’s vaccination chart.

Example: www.immunize.org/catg.d/p2023.pdf

• Send your patients reminders about 

missed vaccines or vaccines that are 

due soon. This can help keep vaccines on your 

patients’ radar and encourage them to stay up to date.

Example: http://www.adultvaccination.org/professional-resources/adult/appointment-reminder-cards.html

• Review how your practice does in keeping your patients up to date on vaccines. 

This can be done by reviewing a sample of patients’ charts or analyzing electronic health record data for your 

practice. Learn more about the CDC Comprehensive Clinic Assessment Software Application (CoCASA) tool here: 

www.cdc.gov/vaccines/programs/cocasa/index.html

To learn more about evidence-based strategies for improving vaccination rates, visit: 

www.TheCommunityGuide.org/vaccines 

CDC’s recommended Adult 

Immunization Schedule is available 

in various formats, including an online 

scheduling tool and mobile phone 

application: 

www.cdc.gov/vaccines/schedules 

Don’t forget to review contraindications and precautions for vaccination when assessing your 

patients’ vaccine needs. 

Learn more: http://www.cdc.gov/vaccines/hcp/admin/contraindications-adults.html

References:

1. Hurley LP, Bridges CB, Harpaz R, Allison MA. US physicians survey regarding adult vaccine delivery: Missed opportunities. Ann Intern Med. 2014; 160:161-70.

2. Nowalk MP, Zimmerman RK, Feghali J. Missed opportunities for adult immunization in diverse primary care office settings. Vaccine. 2004; 22(25-26):3457-63.

3. Nowalk MP, Zimmerman RK, Cleary SM, Bruehlman RD. Missed opportunities to vaccinate older adults in primary care. J Am Board Fam Pract. 2005; 18(1):20-7.

4. Johnson DR, Nichol KN, Lipczynski K. Barriers to Adult Immunization. Am J Med. 2008; 121:528-535. 

For more information and resources on adult immunization, 

visit: www.cdc.gov/vaccines/hcp/adults

Last updated May, 2016