October 14, 2016

Secretary Hillary Clinton
Hillary for America
1 Pierrepont Plz.
Brooklyn, NY 11201

Dear Secretary Clinton:

As participants in the Adult Vaccine Access Coalition (AVAC), we want to take this opportunity to introduce you to our coalition and urge you to prioritize adult immunizations as a means of improving the health of all Americans.

AVAC includes more than fifty organizational leaders in health and public health who are committed to overcoming the barriers to adult immunization and to raising awareness of and engaging in advocacy on the importance of adult immunization. Our mission is informed by a growing body of scientific and empirical evidence that shows that immunization improves health, protects lives against a variety of debilitating and potentially deadly conditions, and saves costs to the healthcare system and to society as a whole.

AVAC works to raise awareness, improve access, and increase utilization of vaccines among adults. Near universal access to immunizations for children has been one of the greatest public health accomplishments of the 20th century. Vaccines protect us from a variety of common diseases that can be serious and even deadly.

Despite the tremendous success of national childhood immunization efforts, adult immunization rates remain woefully low. As a result, every year, more than 50,000 adults die from vaccine preventable diseases and thousands more suffer serious health problems. Despite Advisory Committee on Immunization Practices (ACIP) recommendations, vaccines have been consistently underutilized in the adult population and lag behind the Healthy People 2020 goals for the recommended vaccines (influenza, pneumococcal, Tdap [tetanus, diphtheria, pertussis], hepatitis B, herpes zoster, HPV). Disparities are even greater for at-risk populations, including seniors, communities of color, limited English proficient persons, and people with chronic illnesses.

Adults seeking access to and coverage for vaccines encounter a confusing health care system that presents multiple barriers, including lack of information about recommended vaccines, financial hurdles, as well as technological and logistical obstacles.
For example:
 State Medicaid plans offer some coverage for adult vaccines, though many do not offer access to all ACIP-recommended vaccines;
 Medicare coverage for ACIP-recommended immunizations is fragmented in terms of which providers offer vaccines and how much elderly and disabled beneficiaries may be required to pay to receive them;
 Commercial insurance plans are required to provide access to recommended preventive screenings and immunizations at no cost. However, cost and access barriers to immunization services may still be encountered at the point of care if a patient’s preferred community provider is out of network or does not offer vaccines at all.

Should you become the next President of the United States, we urge you to support innovative solutions that will strengthen and enhance access to and utilization of adult immunization services across the health care system.

This includes:

• Prioritizing the establishment and strengthening of federal benchmarks and quality measures to achieve increased adult immunization rates;
• Enhancing opportunities for provider assessment, patient and caregiver education and counseling on recommended immunization services;
• Removing provider disincentives and administrative burdens to assessing, educating and administering recommended vaccines;
• Improving adult immunization rates among at-risk populations.

Immunization has demonstrated “effective prevention” in reducing rates of morbidity and mortality from a growing number of preventable conditions and has been proven to improve overall health in a cost efficient manner. We ask that you stand with AVAC as we work to make necessary policy changes to increase immunization rates. We would be happy to brief your staff on these important issues at your convenience. Please contact the AVAC Coalition Manager at (202) 540-1070 or info@adultvaccinesnow.org to learn more about the work of AVAC, or visit www.adultvaccinesnow.org.

Sincerely,
American Association of Occupational Health Nurses (AAOHN)
Alliance for Aging Research
American College of Preventive Medicine (ACPM)
Biotechnology Innovation Organization (BIO)
Dynavax
GSK
Hep B United
Hepatitis B Foundation
Immunization Action Coalition (IAC)
Infectious Diseases Society of America (IDSA)
Merck
National Association of County and City Health Officials (NACCHO)
National Council of Asian Pacific Islander Physicians (NCAPIP)
National Hispanic Medical Association (NHMA)
National Viral Hepatitis Roundtable (NVHR)
Novavax
Pfizer
Sanofi
Takeda
The Gerontological Society of America (GSA)