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Providers: Do You Know the Standards for Adult Immunization Practice?

Vaccines aren’t just for children; adults also need certain vaccines to help protect them from preventable disease over the lifespan. During the adult immunization week of National Immunization Awareness Month (NIAM), Rosemary Spence, RN, MA, shares insight into how providers can ensure their adult patients are adequately immunized. 


Even though most insurance plans cover the cost of recommended vaccines, adult vaccination rates in the U.S. are extremely low. As a result, the National Vaccine Advisory Committee (NVAC) updated the Standards for Adult Immunization Practice in 2013 to reflect the need for all health care professionals (whether or not they provide vaccination services) to take steps to ensure adult patients get all recommended vaccines. The Standards for Adult Immunization Practice provide guidance to health care providers. If you’re a provider, here are the steps you should take to help ensure that your adult patients are fully immunized:

Adult Standards of Immunization Practice

ASSESS the vaccination status of patients at every clinical encounter. Missed opportunities to vaccinate can be decreased by assessing patient vaccination status at every clinical encounter. Many adults do not schedule annual check-ups or come in for preventive services, so it is critical to assess vaccination status at every visit. Some vaccines are indicated for adults based on factors other than age, making it important to assess whether additional vaccines may be indicated due to changes in patient lifestyle, health or occupation. The Centers for Disease Control and Prevention’s (CDC) adult immunization schedule can assist providers when assessing patient vaccination status.

There are simple ways to implement routine vaccination assessment into office patient flow. For example, patients may be given a vaccination assessment questionnaire at check-in. The Immunization Action Coalition (IAC) has a vaccination assessment questionnaire, and the CDC has additional tips and tools for implementing routine vaccination assessment into office patient flow.

Strongly RECOMMEND vaccines patients need. A health care provider’s recommendation has been shown to be one of the most important predictors of vaccination. Providers should explain the benefits of getting vaccinated and the potential cost of contracting the diseases vaccines prevent. It’s important to address patient questions and concerns in clear and understandable language. Highlighting positive experiences with vaccination (including the provider’s own, as appropriate) has been shown to strengthen patient confidence in vaccination. The CDC has tips on answering commonly asked questions about adult vaccinations and other resources for use when recommending adult vaccinations.

ADMINISTER needed vaccines or REFER patients to a vaccinating provider. Vaccine delivery can be improved and patient safety ensured by building staff skills and confidence in vaccine administration. The CDC provides self-paced online training and free CE or CME credits, webcasts, and more. The CDC has information about vaccine storage and handling, vaccine precautions and contraindications, and vaccine administration. The IAC also has information for health care providers and their patients. Health care providers who refer patients elsewhere for vaccination should follow up to confirm receipt of recommended vaccines.

DOCUMENT vaccines received by patients. To ensure patients get recommended vaccines and to prevent unnecessary vaccination, health care providers should document vaccinations in patient medical records. Vaccinations can be documented in the Colorado Immunization Information System (CIIS). CIIS is administered by the Colorado Immunization Branch (CIB) and is a confidential, population-based computerized system that collects and consolidates vaccination data for Coloradans of all ages. Health care providers, schools, and child cares use CIIS to document and track the immunization status of their patients/students. For more information about CIIS, please contact the CIIS helpdesk at (303) 692-2437 (select option 2) or

For additional information about increasing adult vaccination coverage, please contact the Colorado Immunization Branch (CIB) at (303) 692-2700 or visit


Rosemary Spence is a Public Health Nurse Consultant and the Adolescent/Adult Immunization Coordinator for the Immunization Branch of the Colorado Department of Public Health and Environment (CDPHE).




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