When you think about vaccines, you may not think about the need for them later in life, but vaccines for older Americans are a critical component of maintaining health as you age. According to the Centers for Disease Control and Prevention, our immune systems weaken over time, which puts older Americans at higher risk for certain diseases. Important vaccines for older Americans include the flu, tetanus, hepatitis A and B, pertussis (whooping cough), pneumococcal, meningococcal, shingles and more.
The Centers for Medicare & Medicaid Services (CMS) recently noted that adult immunization rates remain low, despite the Advisory Committee on Immunization Practices recommendations and Healthy People 2020 targets. CMS encourages Medicare Part D plans to consider offering $0 or low cost-sharing for vaccines. However, many Part D beneficiaries are not getting access to this important benefit at reduced or no cost-sharing.
An analysis by Avalere Health released earlier this year looked at coverage trends from 2011 to 2016 for 10 vaccines recommended for seniors. Avalere found that only 4 percent of the approximately 38 million Part D beneficiaries had access to these vaccines without out-of-pocket costs.
When it comes to vaccines and preventing disease, strengthening access is critical. CMS should continue to encourage Part D plans to cover vaccines at $0 or low cost-sharing and explore other ways to help increase adult immunization rates in the Part D program.
Allyson Funk Ally is a former senior director of public affairs at PhRMA focused on advocacy issues for the biopharmaceutical industry. Her expertise includes Medicare, Medicaid, 340B, health reform and more. Prior to PhRMA, her experience included leading health communications for a large membership organization, supporting public affairs clients and working for the governor of Louisiana.