Adults seeking access to and coverage for vaccines encounter a confusing health care system that presents multiple barriers, including lack of information about recommended vaccines, financial hurdles, as well as technological and logistical obstacles. AVAC is working towards legislative and regulatory solutions that will strengthen and enhance access to and utilization of adult immunization services across the health care system. Our priorities include:


AVAC is committed to improving reporting of adult vaccinations to state immunization registries and encouraging greater utilization of health information technology to track adult vaccination status and improve patient outcomes and care.

Advancements in health information technology create multiple opportunities for greater access and utilization of immunizations among adults. Technology has the power to inform providers about recommended vaccines for the adult population. It can also foster providers’ ability to receive and send information about patients’ immunization status.

Immunization information systems (IIS), also known as registries, are confidential, population-based, computerized systems that record all immunization doses administered by participating providers to persons residing within a given area. IIS systems create a comprehensive, consolidated immunization record for individuals, which can then be used by providers to determine which recommended vaccines may be appropriate for the patient. At the population level, an IIS can also provide aggregate data on immunizations for use in surveillance and program operations, and in guiding public health action with the goals of improving vaccination rates and reducing vaccine-preventable disease.


AVAC supports strengthening and the establishment of additional federal benchmarks and measures to encourage health plans to track, report, and achieve increased adult immunization rates.

Quality reporting measures are an increasingly important tool to track progress and desired outcomes in terms of preventive services benchmarks. Monitoring and reporting of offered and administered immunizations helps to ensure that the range of available immunizations remain a priority and in the forefront of clinical care standards.

Reducing the number of missed immunization opportunities is imperative to improving health and reducing the burden of vaccine preventable disease.

Developing, testing, and integrating additional ACIP-recommended adult immunizations as quality measures and incentive benchmarks under Medicare, Medicaid, and private insurance would help drive utilization and improve patient access to these low-cost preventive services.


AVAC is committed to improving adult immunization rates among at-risk populations.

Despite the health benefits that result from implementation of ACIP recommendations, vaccines have been consistently underutilized in the adult population and lag far behind the Healthy People 2020 goals. These disparities are even greater when looking at-risk populations – including seniors, communities of color, limited English proficient persons, and people with chronic illness.

Though the childhood vaccination program in the United States has been largely successful at reducing or eliminating racial and ethnic disparities in vaccination coverage, minority communities and vulnerable adult populations continue to experience significant disparities in adult immunization rates. For example, African American, Asian, andLatino adults receive recommended vaccinations at rates far below those of whites for every adult-recommended vaccines.

At risk populations, including the frail elderly and pregnant women, also lag behind Healthy People 2020 adult immunization goals, yet are particularly vulnerable to the adverse health consequences of vaccine preventable illness.  Barriers to access through public health programs, such as significant beneficiary cost sharing under Medicare Part D and variations in immunization coverage under state Medicaid programs hinder public health and provider efforts to improve rates among these subgroups.

Targeted efforts are needed to address the specific challenges that vulnerable groups face in order to close the immunization gap and improve adult immunization coverage rates overall.

Recent Letters

June 12, 2017

AVAC Letter to Majority Leader McConnell and Chairmen Hatch, Alexander, and Enzi about AHCA

June 12, 2017 The Honorable Mitch McConnell Majority Leader United States Senate S-230 U.S. Capitol Building Washington, DC 20510 The Honorable Orrin Hatch Chairman Senate Finance Committee 219 Dirksen Senate Office Building Washington, DC 20510 The Honorable Lamar Alexander Chairman Senate HELP Committee 428 Dirksen Senate Office Building Washington, DC 20510 The Honorable Michael Enzi Chairman Senate Budget Committee 624 ...

April 25, 2017

2018 Medicare Advantage and Part D Advance Notice and Final Call Letter

To Whom It May Concern: As participants in the Adult Vaccine Access Coalition (AVAC), we appreciate the opportunity to comment on the Centers for Medicare and Medicaid Services (CMS) 2018 Medicare Advantage and Part D Advance Notice and Final Call Letter. Specifically: • Pneumococcal Vaccination Status for Older Adults (p. 98): AVAC encourages CMS to continue to work with NCQA, ...

March 24, 2017

RE: Proposed Changes to Existing Measure for HEDIS 2017: Pneumococcal Vaccination Status for Older Adults (PNU)

As participants in the Adult Vaccine Access Coalition (AVAC), we appreciate the opportunity to comment on the National Committee for Quality Assurance (NCQA) Proposed New Measure for HEDIS®1 2018: Pneumococcal Vaccination Status for Older Adults (PVS) included in its update to guidelines and measures using electronic clinical data systems (ECDS). We are pleased to offer our support for this measure. ...

March 21, 2017

American Health Care Act (AHCA)

March 21, 2017 Dear Representative, As members of the Adult Vaccine Access Coalition (AVAC), we hope you will ensure Americans of all ages have full access to immunizations that improve health and protect lives as you consider the American Health Care Act (AHCA) and other related health care reform legislation. AVAC includes more than fifty organizational leaders in health and ...

March 3, 2017

Prioritize Funding for Immunization-Related Activities at the Department of Health and Human Services

March 3, 2017 The Honorable Tom Cole Chairman House Labor, Health and Human Services, Education and Related Agencies Subcommittee 2358B Rayburn Office Building Washington, DC 20515 The Honorable Rosa DeLauro Ranking Member House Labor, Health and Human Services, Education and Related Agencies Subcommittee 1016 Longworth House Office Building Washington, DC 20515 Dear Chairman Cole and Ranking Member DeLauro, As members ...

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