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      Adult immunization policies in advanced economies: vaccination recommendations, financing, and vaccination coverage

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          Abstract

          Objectives

          While many countries have robust child immunization programs and high child vaccination coverage, vaccination of adults has received less attention. The objective of this study was to describe the adult vaccination policies in developed countries.

          Methods

          From 2010 to 2011, we conducted a survey of 33 advanced economies as defined by the International Monetary Fund. The survey asked about national recommendations for adults for 16 vaccines or vaccine components, funding mechanisms for recommended adult vaccines, and the availability of adult vaccination coverage estimates.

          Results

          Thirty-one of 33 (93.9 %) advanced economies responded to the survey. Twelve of 31 (38.7 %) reported having a comprehensive adult immunization schedule. The total number of vaccines or vaccine components recommended for adults ranged from one to 15 with a median of 10. Seasonal influenza ( n = 30), tetanus ( n = 28), pneumococcal polysaccharide ( n = 27), and hepatitis B ( n = 27) were the most frequently recommended vaccines or components.

          Conclusions

          Approximately two-thirds of survey respondents do not have a comprehensive adult vaccine schedule, and most do not measure vaccination coverage. We found that a funding mechanism is available for most recommended adult vaccines.

          Electronic supplementary material

          The online version of this article (doi:10.1007/s00038-012-0438-x) contains supplementary material, which is available to authorized users.

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          Most cited references32

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            Rationale for pertussis booster vaccination throughout life in Europe.

            Although the introduction of universal pertussis immunisation in infants has greatly reduced the number of reported cases in infants and young children, disease incidence has been increasing in adolescents and adults in recent years. This changing epidemiological pattern is probably largely attributable to waning immunity after natural infection or vaccination. Furthermore, improved diagnostic testing, active surveillance, changes in disease susceptibility, vaccine characteristics, and increased awareness of the disease might also be contributing factors. Susceptibility to pertussis in adolescents and adults results not only in direct morbidity in these age groups, but also poses a transmission risk to susceptible non-immune infants who are often too young to be vaccinated. Because vaccination schedules vary across Europe, we review the pertussis situation in this region and propose considerations for use of pertussis booster vaccinations at different ages to reduce individual morbidity and transmission from present rates and increase herd protection. Copyright © 2011 Elsevier Ltd. All rights reserved.
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              The future of immunisation policy, implementation, and financing.

              Vaccines have already saved many lives and they have the potential to save many more as increasingly elaborate technologies deliver new and effective vaccines against both infectious diseases--for which there are currently no effective licensed vaccines--such as malaria, tuberculosis, and HIV and non-infectious diseases such as hypertension and diabetes. However, these new vaccines are likely to be more complex and expensive than those that have been used so effectively in the past, and they could have a multifaceted effect on the disease that they are designed to prevent, as has already been seen with pneumococcal conjugate vaccines. Deciding which new vaccines a country should invest in requires not only sound advice from international organisations such as WHO but also a well informed national immunisation advisory committee with access to appropriate data for local disease burden. Introduction of vaccines might need modification of immunisation schedules and delivery procedures. Novel methods are needed to finance the increasing number of new vaccines that have the potential to save lives in countries that are too poor to afford them. Here, we discuss some options. Copyright © 2011 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                +1-202-6901191 , lauren.wu@hhs.gov
                Journal
                Int J Public Health
                Int J Public Health
                International Journal of Public Health
                Springer Basel (Basel )
                1661-8556
                1661-8564
                25 January 2013
                25 January 2013
                2013
                : 58
                : 865-874
                Affiliations
                [ ]National Vaccine Program Office, U.S. Department of Health and Human Services, Washington, DC USA
                [ ]Reparto Malattie Infettive, Istituto Superiore di Sanità, Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Rome, Italy
                [ ]Health Communication and Marketing Group, Health Communication and Technical Training Program, Oak Ridge Institute for Science and Education, Oak Ridge, TN USA
                [ ]Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA USA
                Article
                438
                10.1007/s00038-012-0438-x
                3840285
                23354183
                276b8bc1-8dcc-4184-9518-9c68c70f2e6c
                © The Author(s) 2013

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.

                History
                : 28 June 2012
                : 16 November 2012
                : 29 November 2012
                Categories
                Original Article
                Custom metadata
                © Swiss School of Public Health 2013

                Public health
                vaccine financing,developed country,adult immunization,vaccination coverage,vaccination policy,advanced economy

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