Vaccines a must for seniors


It’s a simple way to keep people healthier while also saving billions of dollars a year in health care spending.

But the idea of vaccinating a larger segment of America’s aging population against influenza, pneumonia and shingles, conditions that impact a huge number of older people, receives little attention.

If that doesn’t change now that the Alliance for Aging Research has made a compelling case for the practice in its newest volume of “The Silver Book: Chronic Disease and Medical Innovation in an Aging Nation,” it’s clear policymakers aren’t serious about improving the nation’s overall heath or in reining in costs. The U.S. spends twice the amount on health care per capita than any other country yet ranks dead last among industrialized countries in health care quality.

Now in its eighth year, “The Silver Book,” available at www.silverbook.org, extracts critical statistics from lengthy studies, with all resources cited.

Consider:

■ About 67 percent of adults age 65 and older receive the flu vaccine annually, but that age group, which accounts for 50 percent of the hospitalizations for the flu, is responsible for 64 percent of the annual total economic burden of influenza, more than $87 billion a year.

■ Though about $1 billion is spent each year on direct medical expenses for shingles in the U.S., just 17.6 percent of those eligible, those 60 and older, receive the shingles vaccine. Yet that age population is responsible for nearly three-quarters of the total annual shingles-related hospital charges.

■ Less than 63 percent of adults age 65 and older receive the pneumonia vaccine each year, yet the annual cost of hospital treatment of pneumonia in Medicare patients is about $7 billion. More than 900,000 seniors suffer with community-acquired pneumonia yearly.

That the numbers of those vaccinated for the three conditions has to increase is beyond argument. There’s simply no way to justify the continuing expense of care, not to mention suffering, for medical problems that can be easily prevented or reduced in impact by vaccinations.

The Centers for Disease Control and Prevention estimates that as many as 90,000 adult deaths each year could be prevented by vaccinations.

If, as “The Silver Book” reports, elderly Medicare patients are hospitalized with community-acquired pneumonia at a rate of 18.3 per 1,000 compared to only 4 per 1,000 in younger populations, isn’t there some way to ensure they get the pneumonia vaccine?

If, as a study has shown, approximately one-third of shingles deaths may be preventable, surely there’s some way to make sure those in the age range most at risk get the vaccination.

In the conclusion to this volume of “The Silver Book,” researchers point to the usual reasons for underutilization of vaccines, including issues of access and cost barriers, lack of education about the benefits of vaccination and misconceptions about the risk.

Dr. Joe Iser, chief health officer for the Southern Nevada Health District, says more education outreach could be done by health officials through TV commercials and visits to senior centers.

I’m sure that would help. But not enough to make the kind of difference necessary to save thousands of lives and big bucks. Given all the health information already aimed at seniors through various media, it’s hard to believe they don’t know vaccinations could help them.

Every now and then on TV, it seems, we see yet another commercial about getting vaccinated for shingles, the viral infection that causes a painful rash. But even though anyone who’s had chickenpox is susceptible to the condition that can result in pain for years, there is no dramatic uptick in vaccinations.

Also remember Medicare already tells beneficiaries which vaccinations are covered under preventive benefits.

(Unlike the flu and pneumonia vaccines, which are paid through Part B, the shingles vaccination is covered by Part D. A Part D prescription drug plan pays for the vaccine itself and for a provider to give the shot. A co-pay is paid at the time of a shingles vaccination, which usually runs between $60 to $80.)

So what must be done to radically change the dismal vaccination rates in seniors?

Given that Medicare largely covers the vaccinations and seniors still don’t get them — which means Medicare (read that taxpayers) often picks up the tab when seniors who refuse vaccinations are hospitalized for what could have been prevented — let’s tie vaccinations to Medicare’s kissin’ cousin, Social Security.

Money, it seems, has a way of making people do the right thing.

So if seniors want their Social Security checks, let’s make them send in proof to program administrators that they’ve received all the vaccinations recommended by the CDC.

To those who say such a practice curtails freedom of choice, keep this in mind: Our children must have their vaccinations in order to go to school.

When it comes to public health, the good of the whole should outweigh the freedom of the individual — and not just when it comes to children.

That mandatory vaccinations of seniors will also save billions of dollars isn’t a bad thing when the U.S. is spending an unsustainable $2.8 trillion a year, 18 percent of gross domestic product, on health care.

As the late Republican Sen. Everett Dirksen once said: “A billion here, a billion there, pretty soon, you’re talking real money.”

Contact reporter Paul Harasim at pharasim@reviewjournal.com or 702-387-2908.