Congress should increase immunization access for seniors

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By Ozlem Equils

Guest Columnist

The COVID-19 pandemic has reinforced the critical role of vaccines in managing public health.

While Los Angeles County, and California more broadly, were once hotbeds of COVID-19 related hospitalizations and death, California now has the lowest COVID-19 transmission rates in the country.

However, these gains are not permanent and the threat from vaccine-preventable illnesses has not abated.

Since the onset of the pandemic, the non-COVID19 vaccination rates have dropped significantly among seniors. In addition, social distancing decreased their exposure to germs, which might have weakened their existing immunity.

As we enter flu and pneumonia season, there are critical steps that policymakers should take to help protect seniors and other vulnerable communities from vaccine-preventable illnesses.

The health and economic threat of vaccine-preventable illnesses are well known. During the 2019-20 flu season, for example, the U.S. Centers for Disease Control and Prevention (CDC) estimated that influenza and pneumonia were associated with 38 million illnesses, 405,000 hospitalizations and 22,000 deaths, with estimated associated spending of $26.5 billion annually for treating the flu, pneumococcal, shingles and pertussis.

As California eases some of its COVID-19 related restrictions such as social distancing and masking, some public health experts are predicting an even worse influenza season than previous years.

Immunizations are particularly important for older adults. Older adults tend to have several comorbidities such as cardiovascular disease and diabetes.

Combined with weaker immune system, seniors have a harder time fighting off diseases such as flu, pneumonia and shingles, which can lead to blindness, stroke, heart attack and consequently hospitalization, long-term illness, decrease in independence and even death.

Despite the alarming consequences of these illnesses and the availability of preventive vaccines, in 2019, only 29% of older adults reported ever receiving a shingles vaccination. That same year, 72% of adults ages 65 and older reported receiving the pneumococcal vaccine and 53% of adults 50 and older received a flu shot in the previous year.

The COVID-19 pandemic has exacerbated declining vaccination rates, as many Californians delayed or cancelled in-person health care visits where routine immunizations are administered.

One significant barrier to broader vaccine uptake among seniors has been the cost that some seniors are forced to pay out-of-pocket for vaccines, and the inconsistent way Medicare covers different immunizations.

For example, some immunizations are covered under the Medicare Part B program without any out-of-pocket costs, while other vaccines covered under Medicare Part D require significant out-of-pocket costs, contributing to low uptake.

Fortunately, there is a bipartisan bill, currently before Congress, that would help raise immunization rates and reduce barriers to access. The Protecting Seniors through Immunization Act would eliminate all costs associated with vaccines, including for those insured through Medicare Part D. The new legislation would provide Medicare beneficiaries access to all recommended vaccines, including shingles and tetanus, diphtheria, and pertussis (Tdap) at no additional cost.

Vaccines are one of the greatest public health tools to prevent the spread of infectious diseases. Roughly 73% of Los Angeles County seniors are fully vaccinated against COVID-19 and an additional 10% are now partially vaccinated at the time of submission of this piece.

We know from our experience with COVID-19 that prioritizing seniors and making vaccines broadly available at no cost and at locations that are most convenient to them helped increase COVID-19 immunization rates and saved lives.

No California senior should have to choose between paying for a life-saving vaccine and their other needs. I urge California’s congressional delegation to support the Protecting Seniors through Immunization Act and to remove cost as a barrier to vaccine uptake for all seniors.

Dr. Ozlem Equils is a pediatrician and member of Immunize LA Families Coalition, a Los-Angeles-based nonprofit aimed at improving immunization coverage and eliminating disparities in vaccine-preventable diseases. 

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