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. AVAC is working towards legislative and regulatory solutions that will strengthen and enhance access to and utilization of adult immunization services across the health care system. Our priorities include:


AVAC is committed to improving reporting of adult vaccinations to state immunization registries and encouraging greater utilization of health information technology to track adult vaccination status and improve patient outcomes and care.

Advancements in health information technology create multiple opportunities for greater access and utilization of immunizations among adults. Technology has the power to inform providers about recommended vaccines for the adult population. It can also foster providers’ ability to receive and send information about patients’ immunization status.

Immunization information systems (IIS), also known as registries, are confidential, population-based, computerized systems that record all immunization doses administered by participating providers to persons residing within a given area. IIS systems create a comprehensive, consolidated immunization record for individuals, which can then be used by providers to determine which recommended vaccines may be appropriate for the patient. At the population level, an IIS can also provide aggregate data on immunizations for use in surveillance and program operations, and in guiding public health action with the goals of improving vaccination rates and reducing vaccine-preventable disease.


AVAC supports strengthening and the establishment of additional federal benchmarks and measures to encourage health plans to track, report, and achieve increased adult immunization rates.

Quality reporting measures are an increasingly important tool to track progress and desired outcomes in terms of preventive services benchmarks. Monitoring and reporting of offered and administered immunizations helps to ensure that the range of available immunizations remain a priority and in the forefront of clinical care standards.

Reducing the number of missed immunization opportunities is imperative to improving health and reducing the burden of vaccine preventable disease.

Developing, testing, and integrating additional ACIP-recommended adult immunizations as quality measures and incentive benchmarks under Medicare, Medicaid, and private insurance would help drive utilization and improve patient access to these low-cost preventive services.


AVAC is committed to improving adult immunization rates among at-risk populations.

Despite the health benefits that result from implementation of ACIP recommendations, vaccines have been consistently underutilized in the adult population and lag far behind the Healthy People 2020 goals. These disparities are even greater when looking at-risk populations – including seniors, communities of color, limited English proficient persons, and people with chronic illness.

Though the childhood vaccination program in the United States has been largely successful at reducing or eliminating racial and ethnic disparities in vaccination coverage, minority communities and vulnerable adult populations continue to experience significant disparities in adult immunization rates. For example, African American, Asian, andLatino adults receive recommended vaccinations at rates far below those of whites for every adult-recommended vaccines.

At risk populations, including the frail elderly and pregnant women, also lag behind Healthy People 2020 adult immunization goals, yet are particularly vulnerable to the adverse health consequences of vaccine preventable illness.  Barriers to access through public health programs, such as significant beneficiary cost sharing under Medicare Part D and variations in immunization coverage under state Medicaid programs hinder public health and provider efforts to improve rates among these subgroups.

Targeted efforts are needed to address the specific challenges that vulnerable groups face in order to close the immunization gap and improve adult immunization coverage rates overall.

Recent Letters

June 2, 2020

AVAC Leads Letter Asking Congress to Invest in Immunization Infrastructure During COVID-19

AVAC led a diverse group of stakeholders in a letter sent to Congressional leadership providing recommendations on how Congress should invest in immunization infrastructure to prepare for the allocation, distribution, and administration of a new COVID-19 pandemic vaccine. The deployment of a safe and effective COVID-19 vaccine is the key to fully re-opening the American economy. And while the existing ...

April 7, 2020

AVAC Letter to Senate Finance Committee on Solutions to Improve Maternal Health

The Adult Vaccine Access Coalition (AVAC) appreciated the opportunity to respond to the Senate Finance Committee’s request for evidence-based proposals to improve maternal health. Low maternal immunization rates are one of the many factors contributing to poor maternal health outcomes in the United States. AVAC made several recommendations including reducing financial barriers for pregnant women; addressing provider issues around billing, ...

January 8, 2020

AVAC Response to Request for Information – PreventionX

December 20, 2019 Ed Simcox HHS Chief Technology Officer U.S. Department of Health & Human Services 200 Independence Ave., SW Washington, DC 20201 RE: Request for Information – PreventionX Dear Mr. Simcox, On behalf of the Adult Vaccine Access Coalition (AVAC), we appreciate the opportunity to share our thoughts in response to the Department of Health and Human Services Chief ...

December 17, 2019

AVAC Comments on the Development of “Cures 2.0”

December 16, 2019 The Honorable Diana DeGette US Representative 2111 Rayburn House Office Building Washington, DC 20515 The Honorable Fred Upton US Representative 2183 Rayburn House Office Building Washington, DC 20515 Dear Representatives DeGette and Upton, The Adult Vaccine Access Coalition (AVAC) appreciates the opportunity to provide feedback that will help shape and inform the development of “Cures 2.0.” AVAC ...

December 12, 2019

AVAC Comments on Executive Order on Modernizing Influenza Vaccines in the United States to Promote National Security and Public Health

December 12, 2019 Robert Kadlec, M.D., MTM&H, M.S., Assistant Secretary for Preparedness and Response 200 Independence Ave., SW, Washington, DC 20201 RE: Comments on Executive Order on Modernizing Influenza Vaccines in the United States to Promote National Security and Public Health. Dear Assistant Secretary Kadlec, On behalf of the Adult Vaccine Access Coalition (AVAC), we appreciate the opportunity to comment ...

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