November 8, 2017

The Honorable Mazie Hirono
United States Senate
330 Hart Senate Office Building
Washington, D.C. 20510

The Honorable Shelley Moore Capito
United States Senate
172 Russell Senate Office Building
Washington, D.C. 20510

The Honorable Larry Bucshon
House of Representatives
1005 House Office Building
Washington, D.C. 20515

The Honorable Gene Green
House of Representatives
2470 House Office Building
Washington, D.C. 20515

Dear Senator Hirono, Senator Capito, Representative Bucshon and Representative  Green:

As members of the Adult Vaccine Access Coalition (AVAC), we would like to take this opportunity to commend you for introducing the Shingles Prevention Act.

AVAC includes more than fifty organizational leaders in health and public health who are committed to overcoming the barriers to adult immunization and to raising awareness of and engaging in advocacy on the importance of adult immunization. Our mission is informed by a growing body of scientific and empirical evidence that shows that immunization improves health, protects lives against a variety of debilitating and potentially deadly conditions, and saves costs to the healthcare system and to society as a whole. Immunization has demonstrated “effective prevention” in reducing rates of morbidity and mortality from a growing number of preventable conditions and has been proven to improve overall health in a costefficient manner. A top priority for AVAC is to achieve increased adult immunization rates through improving education and awareness of recommended vaccines and addressing challenges to access.

Vaccines protect us from a variety of common diseases that can be serious and even deadly. Every year, more than 50,000 adults die from vaccine preventable diseases and thousands more suffer serious health problems. Despite Advisory Committee for Immunization Practices (ACIP) recommendations, vaccines have been consistently underutilized in the adult population and lag behind the Healthy People 2020 goals for recommended vaccines (influenza, pneumococcal, Adult Tetanus, Diphtheria, Pertussis [Tdap], shingles, Human Papillomavirus [HPV], hepatitis B vaccine). Disparities are even greater for at-risk populations, including seniors and people with chronic illnesses.

The Shingles Prevention Act addresses two critical issues impeding Medicare beneficiary access to the Herpes Zoster vaccine: awareness and cost sharing. Medicare beneficiaries often do not realize that coverage for immunizations is divided between Medicare Part B and Medicare Part D. While vaccines under Medicare Part B are available to beneficiaries with no cost sharing or deductibles, beneficiaries face varied cost-sharing requirements for the shingles vaccine under Medicare Part D plans. Your bipartisan legislation would help inform beneficiaries about Medicare coverage for vaccines and would eliminate out-of-pocket costs that significantly hinder access to immunization services under Medicare Part D.

Medicare beneficiaries deserve the same access to protection provided by immunizations as those with commercial coverage currently receive, yet variable cost sharing for vaccines across Medicare programs greatly hinders beneficiary access. Reducing the number of missed immunization opportunities for Medicare beneficiaries is an important step in improving health and reducing the burden of vaccine-preventable illness among this population. It also helps provide protection across the lifespan.

Thank you for your commitment to ensuring that Medicare beneficiaries are aware of the full range of recommended immunizations and to removing financial barriers to access. AVAC members are pleased to offer our support for this important legislation and look forward to working with you toward equitable access and parity of coverage for all ACIP-recommended vaccines for the Medicare population. We look forward to working with you to strengthen and enhance Medicare beneficiary access to this critical preventive service. Please contact an AVAC Coalition Manager at (202) 540-1070 or info@adultvaccinesnow.org or visit www.adultvaccinesnow.org if you wish to learn more about the work of AVAC.

Sincerely,
Alliance for Aging Research
American Association of Occupational Health Nurses (AAOHN)
American College of Preventive Medicine (ACPM)
American Pharmacists Association (APhA)
Asian & Pacific Islander American Health Forum (APIAHF)
Biotechnology Innovation Organization (BIO)
Dynavax
Every Child By Two (ECBT)
GSK
Hep B United
Hepatitis B Foundation
Immunization Action Coalition (IAC)
Infectious Diseases Society of America (IDSA)
Merck
National Association of Chain Drug Stores (NACDS)
National Association of County and City Health Officials (NACCHO)
National Council of Asian Pacific Islander Physicians (NCAPIP)
National Hispanic Medical Association (NHMA)
National Viral Hepatitis Roundtable (NVHR)
Pfizer
Sanofi
Scientific Technologies Corporation (STC)
Takeda Vaccines, Inc.
The Gerontological Society of America (GSA)