and the likelihood of patients ben-efitting from at least one of the activities increases when multiple
interventions are administered together. Therefore, the Task Force on
Community Preventive Services supports combining provider reminder
systems with education and other
measures that encourage use of vaccines in patients and providers. 45
The increasing role of vaccines in
the health maintenance of adults
represents a change in paradigm
for primary care and specialty pro-
viders. Physicians must assess the
value and limitations of vaccines
and find time to discuss immuni-
zations with their adult patients.
Health care systems can increase
opportunities for vaccination and
facilitate encounters that result in
vaccination by educating patients
and health care personnel and
through the innovative use of re-
minders and standing orders in the
EMR. Undertaking these activities
may limit the burden of pneumo-
coccal disease, an important cause
of morbidity and mortality in
adults that is preventable through
This work is dedicated to the memory
of John M. Rieger, Information Technology Specialist at the Cleveland VAMC
and Chief Master Sergeant, Air Force
This work was supported by a research grant from Pfizer and by the
Louis Stokes Cleveland VAMC, the
VISN 10 Geriatric Research Education and Clinical Center, and the
Clinical and Translational Science
Collaborative of Cleveland (award
UL1TR000439 from the National
Center for Advancing Translational
Sciences of the National Institutes of
Health NIH). The content is the responsibility of the authors and does
not represent the official views of the
NIH or the VA.
The opinions expressed herein are those
of the authors and do not necessarily
reflect those of Federal Practitioner,
Frontline Medical Communications
Inc., the U.S. Government, or any of its
agencies. This article may discuss unlabeled or investigational use of certain
drugs. Please review complete prescribing information for specific drugs or
drug combinations—including indications, contraindications, warnings, and
adverse effects—before administering
pharmacologic therapy to patients.
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Figure 2. Pneumococcal Vaccination Rates Through 2014 Among
VISN 10 Veterans With Different Indications for Vaccinationa
aData extracted from VISN 10 electronic data warehouse; vaccination data from patients who received
vaccination by providers outside of VHA may not have been captured; shading reflects the proportion of
patients vaccinated with PCV- 13 alone (darkest), PPSV- 23 (medium), both, or neither (white); note that
percentages add to 100 and patients who received both vaccines are counted only once.