Clinical Review

New Developments in Adult Vaccination: Challenges and Opportunities to Protect Vulnerable Veterans From Pneumococcal Disease

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Related: Venous Thromboembolism Prophylaxis in Acutely Ill Veterans With Respiratory Disease

Patient reminder and recall systems also demonstrated effectiveness in improving immunization rates.43 In certain groups, notification of patients has been achieved through electronic methods, such as short text messaging or e-mail.44 Determining which interventions within a bundle are essential may be impossible, because the various interventions reinforce one another, and the likelihood of patients benefitting from at least one of the activities increases when multiple interventions are administered together. Therefore, the Task Force on Community Preventive Services supports combining provider reminder systems with education and other measures that encourage use of vaccines in patients and providers.45

Box answer key: 1: A; 2: A; 3: B; 4: A.


The increasing role of vaccines in the health maintenance of adults represents a change in paradigm for primary care and specialty providers. Physicians must assess the value and limitations of vaccines and find time to discuss immunizations with their adult patients. Health care systems can increase opportunities for vaccination and facilitate encounters that result in vaccination by educating patients and health care personnel and through the innovative use of reminders and standing orders in the EMR. Undertaking these activities may limit the burden of pneumococcal disease, an important cause of morbidity and mortality in adults that is preventable through immunization.

This work is dedicated to the memory of John M. Rieger, Information Technology Specialist at the Cleveland VAMC and Chief Master Sergeant, Air Force Reserve.

Author Disclosure
This work was supported by a research grant from Pfizer and by the Louis Stokes Cleveland VAMC, the VISN 10 Geriatric Research Education and Clinical Center, and the Clinical and Translational Science Collaborative of Cleveland (award UL1TR000439 from the National Center for Advancing Translational Sciences of the National Institutes of Health NIH). The content is the responsibility of the authors and does not represent the official views of the NIH or the VA.

The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the U.S. Government, or any of its agencies. This article may discuss unlabeled or investigational use of certain drugs. Please review complete prescribing information for specific drugs or drug combinations—including indications, contraindications, warnings, and adverse effects—before administering pharmacologic therapy to patients.


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