Primary care physicians in ideal position to improve vaccination rates

Glen Stream, M.D., calls them “miracles of modern medicine”--those vaccines that have virtually wiped out diseases such as polio, diphtheria and measles in the U.S. and eradicated smallpox around the world.

Yet, people in the United States continue to get diseases, from viral hepatitis to influenza, that vaccines can prevent, putting primary care doctors on the frontline to improve immunization rates, writes Stream, a family physician who practices in La Quinta, California, in a blog post on Medical Economics.

A high proportion of family doctors (80 percent or more) reported providing routinely recommended child, adolescent and adult vaccines in a 2008 survey by the American Academy of Family Physicians (AAFP), says Stream, who is past president of the group.

The patient-centered medical home approach is one way to improve immunizations, he says. A three-year pilot program initiated by the AAFP that began with 20 physician practices across the country used that approach and successfully increased adolescent immunization rates for Tdap, influenza, HPV and other vaccine-preventable diseases, he says. In the final phase of the pilot, which ended in 2015, practices increased immunization rates ranging from 11 percent for annual flu shots to 74 percent for female patients and 429 percent for males for the full HPV vaccine

“Because we’re connected to our patients--young, old and in-between--from cradle to grave, family physicians are in an ideal position to improve immunization rates. That continuity of care results in better preventive care and helps ensure that patients with a medical home get the immunizations they need when they need them,” he writes.

But whether vaccines should be mandatory continues to generate controversy. A new study, published in Cancer Epidemiology, Biomarkers & Prevention, found just 21 percent of American parents support mandating HPV vaccines for adolescents before entering school. Having an opt-out provision almost tripled parents’ support for HPV vaccine school-entry requirements, but that may the idea of a mandate ineffective, the researchers said. The survey may indicate the need for more education about the benefits of the immunization, as only 40 percent of parents surveyed agreed that the HPV vaccine was helpful in preventing cervical cancer.  

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