HJLR Mar/Apr 2019

dialogue 22 MAR / APR 2019 I  Healthcare Journal of LITTLE ROCK   Why are you working so hard to cham- pion for immunization from preventable diseases? Immunization against infectious diseases is one of the greatest successes of the past two centuries. Vaccines against infectious diseases have improved the health of our population, yet remain an underutilized intervention, particularly in adults and adolescents. The cost of our current health care system—better termed sick care sys- tem—is unsustainable. There is tremendous upside for more consistent use of immuni- zation, diet, exercise, smoking prevention/ cessation, and other preventive methods to reduce the cost of health care and improve the health of Arkansans and people across our great nation. What is it that all health care providers should be mindful of regarding vaccina- tion and immunization? Vaccines are safe, effective, and unde- rused in outpatient, hospital, and other health care settings. Immunization using evidence-based strategies (strong provider recommendations, standing orders, provid- ing vaccination at all visit types, etc.) can help us better protect our families, staff, and patients. There is also a myth that vaccina- tion is a financial loss-leader for physician practices. This is not true if good business practices are applied to vaccinations in the office setting. Can you give some statistical data regarding vaccination and immunization for Arkansas? How many children are fully immunized? Adults? Success rates? Pre- ventable diseases? Arkansas is in the lowest quintile of school-aged children with complete vacci- nation, according to national guidelines, and we also have a high rate of vaccine exemp- tions. Rates for adolescents vary in compar- ison to other states, with Arkansas having a relatively low rate for HPV vaccination, and higher rates for varicella, MMR, and Tdap vaccination. Adult vaccination rates are lower than the national average. We are seeing some improvements but still have a long way to go. What are the biggest barriers to proper vaccination and immunization? Immunization barriers fall into three major buckets: hesitancy/demand, advo- cacy/implementation, and access. Many patients and families do not understand the benefits and value of immunization. Education, particularly if delivered by their trusted physician, can help overcome this in most cases. Unfortunately, a subset of the population that mistrusts or has con- cerns about the benefit vs. risk of vaccines has existed since the days of Edward Jen- ner and the introduction of variolation to prevent smallpox. Those who have these anti-vaccine beliefs will always be difficult to protect. In the advocacy/implementation area, it is critical that all members of our health care teams are educated about basic vaccine science (who, what, when, why, and how to vaccinate), work in practice-based teams to vaccinate our patients effectively using the rule book updated annually by the CDC’s Advisory Committee on Immuniza- tion Practices and record these vaccines in a lifetime immunization registry (such as Arkansas WebIZ). Finally, there are too “Arkansas is in the lowest quintile of school-aged children with complete vaccination, according to national guidelines, and we also have a high rate of vaccine exemptions”