As a family physician practicing for more than 35 years, and Board Member of the National Hispanic Medical Association, Dr. Minerva Campos knows that immunizations prevent numerous diseases. That’s why she needs to stock a lot of vaccines for both children and adults.
Dr. Campos follows the National Vaccine Advisory Committee (NVAC) Immunization Standards for Adult Immunization Practice, which advise all physicians to: 1) provide a vaccine assessment at every visit, 2) provide a strong, clear immunization recommendation, 3) administer vaccine or refer if vaccine is not in stock, and 4) document vaccinations.
Yet there are a number of challenges doctors face when it comes to stocking and administering vaccines, especially for adult patients. A family physician’s office, for example, needs to have an internal infrastructure in place that includes many components:
- Obtaining support and cooperation from clinical staff,
- Seeking out community resources
- Assigning a vaccine coordinator
- Planning workflow and workspace
- Purchasing vaccine storage equipment, administration supplies, and emergency response supplies
- Arranging for staff training
- Organizing vaccination paperwork and reference materials
- Creating standing orders documents
- Ordering vaccines
This internal vaccine infrastructure is critical, but it’s only the first set of steps. The physician then needs to determine where a patient falls under the reimbursement system. Here too, there are a variety of payer mechanisms to navigate, including private insurance, Medicare Part B Medicare Part D, Medicare Advantage (Part C), Medicaid, and Military/VA…not to mention those people don’t have insurance at all. Depending on the plan, patients may have to pay quite a bit in out-of-pocket costs, or nothing. The office has to help figure that all out before the patient actually gets the vaccine
Dr. Campos knows firsthand how complex it is to navigate the immunization infrastructure and payment processes, especially the adult Hispanic population. Hispanics are the largest ethnic minority group in the United States—54 million, or 17 percent of the total population. Despite the strength in numbers, Hispanic populations tend to lag behind when it comes to health, and those disparities extend to immunizations. Although racial/ethnic disparities in childhood vaccination coverage have improved throughout the past decade, substantial disparities among adults aged ≥65 years have persisted. In fact, deaths from pneumonia and influenza combined are the 10th leading cause of death among Hispanics.
Dr. Campos has worked diligently to improve preventive care through targeted strategies to effectively reach Hispanic adults of all ages. In 2015, she helped draft a toolkit to assist health care providers increase vaccination rates in Hispanic communities. Developed by the National Hispanic Medical Association (NHMA), in collaboration with the Centers for Disease Control and Prevention (CDC) and the Association of State and Territorial Health Officials (ASTHO), the toolkit highlights barriers to immunizations and offers suggestions to providers on ways to improve access to and awareness of vaccines for Hispanic adults. It is a bilingual, consumer-friendly guide that includes valuable information about vaccine schedules, vaccine safety information, and ways to utilize technology to document vaccines.
With providers like Dr. Campos working hard every day to increase immunizations among Hispanic adults, we will make progress and change lives. http://www.census.gov/newsroom/facts-for-features/2014/cb14-ff22.html  http://www.cdc.gov/minorityhealth/CHDIR/2011/FactSheets/FluVaccine.pdf  http://www.cdc.gov/minorityhealth/populations/REMP/hispanic.html#10