Increasing Access to Adult Immunization in Massachusetts


Massachusetts, with an estimated population of 6.4 million people, has been providing vaccines for the people of the Commonwealth for more than 100 years. Residents of Massachusetts benefit from a universal select childhood vaccine program, and Massachusetts has some of the highest childhood vaccination rates in the nation. Adults, however, have less access to vaccine supplies, services, and information, and rates have lagged behind.

There are many reasons for low vaccination rates among adults. These include a complex adult vaccine schedule, a lack of access to vaccination services, a lack of insurance coverage, suboptimal health care provider practices, and a lack of information among both health care providers and consumers. Despite these barriers, increasing the immunization of adults can substantially reduce morbidity and mortality from infectious diseases.

Since the fall of 2011, JSI has been assisting the Massachusetts Department of Public Health (MDPH) on a two-year adult immunization infrastructure project.  The project goal is to reduce vaccine-preventable morbidity and mortality by increasing adult vaccination rates through expanded access to vaccination services.  The project focuses on all 10 of the Advisory Committee on Immunization Practices (ACIP)-recommended vaccines for adults and is based on achieving the Healthy People 2020 goals.* JSI works in the following fronts to increase adult immunizations in Massachusetts:


Health plan billing:

–          Local public health departments, pharmacies, and community health centers are critical providers of population-based public health services, including immunizations.

–          JSI is working with private and public health plans to create systems to provide reimbursement for flu shots and other adult vaccinations administered at local public health clinics.

–          The goal is to eventually ensure that all 10 of the ACIP-recommended vaccines for adults are included as preventive benefits for adults. The increased revenue to local health departments can help ensure that these services remain sustainable.


Immunization Information System:

–          There is a strong national effort to improve patient immunization coverage rates through provider use of Immunization Information Systems (IIS), commonly referred to as Immunization Registries.

–          JSI is assisting Massachusetts with the development, testing, rollout, and enrollment of providers in the Massachusetts Immunization Infrastructure System (MIIS), a statewide electronic system for all childhood and adult vaccinations. JSI also operates the MIIS Help Desk, where staff members provide programmatic and technical assistance to users of the MIIS.

–          Health care providers, pharmacies, community health centers, and others will enroll in the MIIS to increase the consolidation of and access to vaccination data by health care providers across the state.


Training, education, and communication:

–          JSI provides needs assessments and evidence-based training programs to employers and community health centers to create organizational change to offer vaccines through enhanced delivery systems.

–          JSI manages the Massachusetts Adult Immunization Coalition, a collaborative partnership dedicated to increasing adult immunization through education, networking, and sharing of innovative and best practices.

–          JSI also runs the coalition’s annual adult immunization conference.* This conference attracts professionals from local public health organizations, long-term-care facilities, pharmacies, college health, hospitals, physician practices, community health centers, vaccine manufacturers, and more. It has proven to be a valuable venue for continued learning and interaction with key immunization experts.

* This year’s Massachusetts Adult Immunization Conference will take place on May 21, 2013 at the DCU Center in Worcester, MA. Highlights include a keynote address by Carolyn Bridges, MD, Associate Director of Adult Immunizations at the CDC, and workshops on topics ranging from vaccination challenges during natural disasters, to traveler health, to using social media to promote adult immunization. To find out more, and to register now, visit the conference registration website.

*The ACIP-recommended vaccines for adults are: influenza; tetanus, diphtheria, pertussis (Td/Tdap); varicella; human papillomavirus (HPV); zoster; measles, mumps, rubella (MMR); pneumococcal; meningococcal; hepatitis A, hepatitis B.  More information about can be found at: or

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