Increasing Access to Adult Immunizations in Massachusetts

Massachusetts has been providing vaccines for the people of the Commonwealth for more than 100 years. Residents benefit from a universal select childhood vaccine program and some of the highest childhood vaccination rates in the nation. Adults, however, have less access to vaccine, vaccine services and vaccine information, and rates have lagged behind. There are many reasons for low vaccination rates among adults that have to do with the knowledge, beliefs and practices of both health care providers and consumers.

In 2006, Massachusetts enacted comprehensive health reform legislation, resulting in health care coverage for more than 98% of residents. The remaining uninsured are more likely to be young, single, male, non-elderly low-income adults, and/or of Hispanic ethnicity. Virtually the only access to primary care and vaccination services for the remaining 2% of residents who are uninsured is through community health centers.

In 2011, JSI began assisting the Massachusetts Department of Public Health (MDPH) on an adult immunization project whose goal is to increase adult vaccination rates through expanded access to vaccination services. The project focuses on all 10 of the Advisory Committee on Immunization Practices (ACIP)-recommended vaccines for adults and is based on achieving the Healthy People 2020 goals.* The primary measure used by MDPH for measuring adult vaccination rates is the Behavioral Risk Factor Surveillance System (BRFSS).

The project activities consist of:

• Providing technical assistance and training to pharmacies, employers, and community health centers to expand adult vaccination efforts using evidence-based strategies
• Working with MassHealth (the state Medicaid agency) and private health insurers on policy to provide reimbursement for all adult vaccines administered to adults in traditional settings as well as non-traditional settings such as pharmacies and local health departments.

Additionally, the Massachusetts Immunization Information System (MIIS) is currently being rolled out in the state. Pharmacies, commercial vaccinators who provide vaccination for employers, and community health centers will enroll in the MIIS to increase the consolidation of and access to vaccination data by health care providers across the state.

In 2013, MDPH expanded JSI's contract to include the management of the Massachusetts Adult Immunization Coalition as well as the Annual Massachusetts Adult Immunization Conference which is the largest activity of the Coalition. The Coalition launched a new website.

*The ACIP-recommended vaccines for adults are: influenza; tetanus, diphtheria, pertussis (Td/Tdap); varicella; human papillomavirus (HPV); zoster; measles, mumps, rubella (MMR); pneumococcal; meningococcal; hepatitis A and hepatitis B. More information about can be found at: www.immunize.org or www.cdc.gov