Don’t put elderly Texans at risk

According to the Centers for Disease Control and Prevention, this year alone the United States has experienced 839 new cases of confirmed measles; a long-forgotten disease now currently a growing healthcare problem. Texas is one of 23 states experiencing a measles outbreak. It is of great importance to understand that vaccinations are not only required for children. 

Older adults also need vaccines for life threatening diseases such as pneumonia. 

In the United States alone, according to the CDC, there are 400,000 annual hospitalizations of adults 65 or older as a result of pneumococcal pneumonia infections. 

In 25 to 30% of these cases, patients with pneumococcal pneumonia the disease course may complicate with pneumococcal bacteremia. The results of this complication cause a death rate of 5 to 7% among those infected. 

Despite these numbers, the CDC’s Advisory Council on Immunization Practices is considering dropping the recommendation for one of the vaccines that protects against specific strains of pneumonia.

The CDC is ignoring the fact that adult vaccinations are just as critical as child vaccinations, while considering a decision that would impact seniors having access to vaccines. ACIP could make a decision as early as June, deciding to accept or drop the existing recommendation that adults 65 or older receive a vaccine that prevents pneumococcal disease, thus putting at risk the health of our senior citizens.

As nurse practitioners, we follow the standards of care that are in place for disease prevention in patients of all ages and cultures. Vaccinations are standards of care as patients acknowledge and follow the recommendations given by their primary care providers. Patients rarely proactively ask for a vaccine, their trust rests on their PCP recommendations. Dropping this recommendation will only cause confusion and distrust in addition to potential health risks. 

There are social, economic and cultural considerations that factor into the reasons our minority populations are less likely to be vaccinated. The lower vaccination rates make this population a higher risk one for contracting vaccine-preventable diseases such as pneumococcal pneumonia.

The members of our Houston chapter of the National Association of Hispanic Nurses are particularly concerned about vaccinations in the elderly. The National Foundation for Infectious Diseases indicates that only 60% of seniors 65 years of age and older are vaccinated. In the Hispanic population, the vaccination rate is at 43%. This is disheartening, especially when the U.S. public health goal is to have 90% of seniors vaccinated.  

When it comes to pneumococcal vaccine specifically, Hispanics are among the highest risk populations according to the U.S. Department of Health and Human Services. These rates are at a low 20%, indicating that high-risk Hispanics are less likely than non-Hispanic white adults to have received the vaccine. For the state of Texas, where 40% of the population is Hispanic, this information quantifies as an increased healthcare risk. 

Any further move to eliminate the number of available vaccines could result in an unintended consequence in vaccination rates for the elderly. 

Emilia Cordero MS, RN, ANP-C, Ed.D-c, is a member of the National Association of Hispanic Nurses Houston Chapter.


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