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Supplements A Managed Care Perspective on the Importance of Optimizing Influenza Vaccinations in Older Adults
Influenza in Older Patients: A Call to Action and Recent Updates for Vaccinations
Miranda Wilhelm, PharmD
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Managed Care Considerations and Economic Implications of Vaccination Practices
Mary Patricia Nowalk, PhD, RD
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Managed Care Considerations and Economic Implications of Vaccination Practices

Mary Patricia Nowalk, PhD, RD
Underusage of influenza vaccine in adults 65 years or older remains a critical concern in medical practice in the United States. To successfully address the health and economic burden of influenza and benefits of immunization, change is needed at the health-system, provider, and patient levels. Strategies for health systems include recognition of the cost-effectiveness of influenza vaccination, of alternative vaccination strategies, and of interventions at the practice level to improve vaccination rates; facilitation and implementation of SOPs; programming the EMR rates for provider immunization reminders; and instituting feedback on rates to providers. Strategies for providers include support of vaccination assessment and administration by nonphysician staff, use of available toolkits for increasing vaccination rates, and providing release time for the immunization champion to foster motivation among staff. Patient-level strategies include efforts by providers, such as creating or procuring age-, language-, and health literacy-appropriate patient education materials; holding staff in-service sessions to prepare for influenza vaccination season; and recommendation of influenza vaccine by all members of the office staff so patients understand that it is a health priority. A concerted effort among providers and agencies, including clinicians, health systems, government agencies, community advocates, and families, can improve vaccination rates for older adults and reduce their annual morbidity and mortality from influenza.

Author affiliation: University of Pittsburgh School of Medicine, Pittsburgh, PA.
Funding source: This activity is supported by an educational grant from Sanofi Pasteur U.S.
Author disclosure: Dr Nowalk reports receiving grants/research support from Merck & Co., Inc., and Pfizer, Inc.
Authorship information: Concept and design, drafting of the manuscript, and critical revision of the manuscript for important intellectual content.
 
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