By Bentley Lipscomb
Vaccinations are truly one of the health care industry’s greatest success stories. Immunizations are credited with preventing an estimated 14 million cases of disease and avoiding 33,000 deaths a year.
Access to vaccines, especially for at-risk populations, should be embraced as a national imperative. That’s why Florida’s senior population should pay close attention to two impending policy decisions that will decide if access to life-saving vaccinations is expanded or blocked.
Both decisions – one at the state level, one at the federal level – will impact access to vaccines that combat pneumonia. Here in Florida, about three million cases of pneumonia are reported each year, with fully a third afflicting people over age 65. Yet, shockingly, Florida ranks near the very bottom when it comes to vaccinating seniors against pneumonia, with nearly 38% of those 65 and older remaining unvaccinated.
Florida can significantly improve that picture if the Florida Legislature adopts HB 509/SB 850, allowing pharmacists to administer vaccines for pneumonia and shingles. Currently, pharmacists in 45 states are permitted to administer the pneumonia vaccine, but, in Florida, the only vaccine pharmacists can offer is the influenza vaccine.
In the five years since qualified Florida pharmacists have been authorized to administer influenza immunizations, the program has been an unqualified success. Influenza immunization rates are up, hospitalizations for flu are down and not a single adverse incident has been reported.
The availability of the pneumonia vaccine at pharmacies, which are located on nearly every major street corner, is a boon to access, since the average Floridian visits a pharmacy at least once a month. Given that vaccinations in pharmacies are available on demand and don’t require a scheduled appointment, Florida’s pneumonia vaccination rate is sure to rise if this legislation passes.
While the prospects for that legislation look promising, another pending policy decision that could turn the tide on pneumonia deaths among seniors appears to be in peril.
On Dec. 30, the U.S. Food and Drug Administration approved an important new cutting-edge biologic vaccine to prevent pneumonia, Prevnar 13, for people ages 50 and over under the agency’s accelerated approval pathway. This process allows earlier approval of treatments for serious and life-threatening illnesses.
The last step on the road to access is a recommendation from the Centers for Disease Control’s Advisory Committee on Immunization Practices (ACIP), which is normally a quick process.
Unfortunately, it seems it won’t be a quick or routine process in this case. While ACIP was originally slated to vote on a recommendation at its next meeting on Feb. 23 now it is scheduled only to discuss the issue. This creates a certain delay, since ACIP only meets three times a year. The rationale for the delay is unclear.
As Forbes recently reported, “Safety isn’t an issue; the clinical trials included 6,000 people ages 50 or older and the vaccine was found to be safe. Nor is efficacy an issue. The FDA declared: ‘The studies showed that for the 12 common serotypes, Prevnar 13 induced antibody levels that were either comparable to or higher than the levels induced by Pneumovax 23 [an existing vaccine for this age group].’”
Without a recommendation from ACIP, the vaccine will not be available to a large number of Americans, since ACIP approval usually means that Medicare and Medicaid will pay for the vaccine, and private health insurance will follow suit.
Given that an estimated 300,000 adults 50 and over will be hospitalized with pneumonia this year, this delay is sure to be deadly.
Our lawmakers and policymakers need to embrace and expedite both of these policy positions, giving our seniors access to life-saving weapons in the fight against pneumonia.
Bentley Lipscomb is the former Secretary of the Florida Department of Elder Affairs and former state director of AARP Florida.
