Many Older People Skip Vaccinations.

“New Old Age” blog reported on “an ongoing and vexing public health problem: People once vigilant about vaccinating their children aren’t nearly as careful about protecting themselves as they age, even though diseases like influenza, pneumonia and shingles...are particularly dangerous for older people.” Dr. Carolyn Bridges, associate director for adult immunization at the CDC, said, “Trying to prevent these common and often debilitating conditions is incredibly important for older adults.” http://www.nytimes.com/2016/12/02/health/shingles-vaccine.html?action=click®ion=rank&module=package&version=highlights&contentPlacement=2&pgtype=sectionfront Why these missed opportunities? “Vaccines are less likely to be routinely incorporated in adult medical practice,” Dr. Bridges said. “Every time a child comes in, a pediatrician makes sure they’re up-to-date.” Older adults often have medical issues that take precedence during brief office visits. They also see specialists who are more focused on cardiology or oncology than on flu and shingles. The vaccine’s underuse can be blamed, in part, on supply shortages in its early years until about 2012. Cost remains a barrier to getting Zostavax and some other adult vaccines. In a study published this past summer, researchers reported that nearly 40 percent of the time, patients over 50 who requested a prescription for Zostavax at a pharmacy chain chose not to receive the vaccine; out-of-pocket costs were most frequently the reason. The Affordable Care Act requires private insurers to cover Zostavax without co-pays for people older than 60, and many cover it for policyholders over 50. But Medicare beneficiaries find that, unlike the flu and pneumococcal vaccines, which are covered under Part B and often administered in physicians’ offices, Zostavax and Tdap are covered under Part D. Physicians can’t easily bill for Part D reimbursement, so they often send patients to pharmacies, which can. But because Part D involves a welter of different plans and formularies, some requiring patients to pay for the vaccine and then seek reimbursement, the cost and co-pays can discourage use. Zostavax, at about $200 a dose, is the most expensive adult vaccine.