Call to Action to Boost Low Adult Immunization Rates in the US 

The National Adult and Influenza Immunization Summit (NAIIS), co-led by CDC, HHS, and Immunization Action Coalition, released a Call to Action following data that showed at least 3 out of every 4 adults are missing one or more routinely recommended vaccines. It is vital to increase immunization rates to protect adults from vaccine-preventable diseases, so the NAIIS urges all healthcare providers to implement strategies that will improve routine vaccinations of adults.

August 23, 2021

Dear Colleague,

Vaccinations are critical components of routine healthcare for adults. They provide protection against severe illness, disability, and death from 15 different infectious diseases such as influenza, pneumococcal disease, herpes zoster (shingles), hepatitis A, hepatitis B, HPV-related cancers, tetanus, and pertussis (whooping cough). The enormous impact of COVID-19 vaccines on reducing illnesses, hospitalizations, and deaths further demonstrates the immense value of vaccines.

Despite the tremendous benefit of vaccines, at least 3 out of every 4 adults are missing one or more routinely recommended vaccines. Given the recognized health benefits of adult vaccinations and low rates of adult vaccination, made worse by the COVID-19 pandemic, the National Adult and Influenza Immunization Summit (NAIIS) members call on providers across the healthcare spectrum to take actions to improve vaccination of adults.

Specifically, NAIIS calls on all clinicians and other healthcare providers, such as pharmacists, occupational health, and clinical subspecialists, to follow the National Vaccine Advisory Committee’s (NVAC) Standards for Adult Immunization Practice including:

  • Assess the vaccination status of patients at all clinical encounters, even among clinicians and other providers who do not stock vaccines.
    • Utilize a jurisdiction’s immunization information system (IIS) to view patients’ prior vaccinations to support vaccine needs assessment.
  • Identify vaccines patients need, then clearly recommend needed vaccines.
  • Offer needed vaccines or refer patients to another provider for vaccination.
  • Document vaccinations given, including in the jurisdiction’s IIS.
    • Many electronic health record (EHR) systems already link to jurisdictions’ IISs – providers should check with their EHR administrators.
    • Providers not already utilizing an IIS should contact their local or state immunization program to inquire about enrolling in their jurisdiction’s IIS.
  • Measure vaccination rates of providers’ patient panels; make changes to clinic patient flow and take other steps to address barriers to patient vaccination.

Taking these actions will help protect adults across the U.S. against preventable illness, disability, and death.

Resources for implementation of the Standards for Adult Immunization Practices can be found at

For a list of NAIIS members supporting the Standards, visit

For additional background information on the Adult Immunization Call to Action, see the Immunization Action Coalition’s website at

Thank you for protecting the health and safety of adults nationwide.

Melinda Wharton MD, MPH
Immunization Services Division
National Center for Immunization and Respiratory Diseases

Ram Koppaka, MD, PhD (CAPT, USPHS)
Medical Officer
Associate Director, Adult and Influenza Immunization
Immunization Services Division
National Center for Immunization and Respiratory Diseases


1. CDC/ACIP Adult Immunization Schedule. (accessed June 18, 2021).

2. Christie A, et al., Decreases in COVID-19 Cases, Emergency Department Visits, Hospital Admissions, and Deaths among Older Adults following the Introduction of COVID-19 Vaccine — United States, September 6, 2020–May 1, 2021. MMWR Morb Mortal Wkly Rep 2021;70:858–864. doi:

3. Lu P, Hung M, Srivastav A, et al., Surveillance of Vaccination Coverage among Adult Populations—United States, 2018. MMWR Surveill Summ 2021;70(No. SS-3):1–26. doi:

4. Avalere. Updated Analysis Finds Sustained Drop in Routine Vaccines through 2020. Avalere Insight, June 9, 2021. (accessed June 29, 2021).

5. Nyaku, Mawuli, Unpublished data. Presented to National Adult and Influenza Summit, July 15, 2021.

6. National Vaccine Advisory Committee. Recommendations from the National Vaccine Advisory Committee: Standards for Adult Immunization Practice. Public Health Rep 2014;129(2):115–23. doi: 10.1177/003335491412900203.

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