Everything is bigger in Texas — except when it’s not: A Texan reflects on #NIAM
Aug 04, 2016

In recognition of National Immunization Awareness Month (#NIAM16), Every Child By Two’s #StateofTheImmUnion campaign will highlight the importance of vaccines throughout the lifespan.  We are excited to present the first in a series of guest posts from colleagues throughout the nation who will provide their perspective on the topic of the week for #NIAM16.

The following post focusing on adult vaccines was written by Anna Dragsbaek, President and CEO of The Immunization Partnership, a Texas-based non-profit organization dedicated to the eradication of vaccine-preventable diseases through education, advocacy for science-based immunization policy and the support of immunization best practices.

During this week of National Immunization Awareness Month, it’s a good time to reflect on how we are doing as a state and as a nation with vaccinating our communities, including adults. And while Texas is the best state in the union for a number of reasons, when it comes to vaccinating our adults, we have some work to do.

Bigger isn’t always better.

Fewer than half of Texas adults got the flu vaccine last season — far short of the Healthy People 2020 objective of 70 percent. Why is this? Some of it has to do with the things that are bigger — but that we wish weren’t. Take, for instance, the percentage of people whose access to vaccinations might be limited by their lack of health insurance. According to the Texas Medical Association, one in four adults in Texas don’t have medical insurance; nationwide, the number is one in six, the CDC reports.

The Adult Safety Net Program is designed to help uninsured adults gain access to vaccines by providing low-cost immunization — and it does help. Many adults are able to access to vaccines who otherwise wouldn’t be able to because of this program. But it can only do so much. And all too often adults live in areas where they don’t have access to an Adult Safety Net provider, don’t qualify for the program themselves, or area providers don’t offer all the vaccines recommended by the CDC.

And even those with insurance can find it difficult to gain access to vaccination for other reasons.

Texas has the largest rural population in the country — a fact that becomes abundantly apparent on the roughly 11-hour drive from Houston to El Paso. The entire state takes up more than 260,000 square miles. To put that into perspective, that’s nearly the square footage of neighboring states New Mexico, Oklahoma, Arkansas and Louisiana combined.  With so much ground to cover, many in the state have to travel long distances to see a healthcare provider. And because not all providers participate in the Adult Safety Net Program, the distance that uninsured Texans must drive can be significantly longer — even though these tend to be the people who can least afford the time and gas for a long drive.

But perhaps most importantly, many adults — especially young adults —simply don’t know that immunizations are recommended not just during childhood or when you’re in school, but also from age 19 on.

That could be, in part, due to the infrequency with which adults seek preventative care from their health home. Primary care providers (PCP) are often the chief health educators for families of all ages, and if adults aren’t seeing their PCPs (because of lack of insurance or access issues), they might not be getting information on what vaccines they might need and why.

But if anyone is up for a challenge, it’s Texans.

This spring we traveled across the state of Texas to talk with more than 700 healthcare providers, public health officials and vaccine advocates about what they experience on the ground as they work to protect our communities. And one thing is abundantly clear: Texans protect Texans. There are a lot of hard-working people throughout this great state who are committed to doing what they can to improve immunization rates across the lifespan and protect our communities from needless suffering as a result of vaccine-preventable diseases.

Community health workers are putting together health fairs to offer free flu vaccines for adults in Houston. Coalitions are working together in West Texas, the Panhandle and the Rio Grande Valley to educate and vaccinate adults in their communities. And stakeholders are working with the Texas state government in Austin to expand the vaccines available to uninsured adults and improve the statewide immunization registry to promote adult participation.

Things look like they’re getting better.

During the 2010-2011 flu season, about 40 percent of Texas adults were vaccinated against flu. In 2014-2015? That number was 45 percent. Sure, the progress is slow. And to move the needle even further, we’ll have to come together as a state to educate the adult population and push for laws and policies that could help improve access and uptake.

If there’s one thing we can be bigger — and better — at, it’s working together for better health for adults and families. But we’re Texans after all. We don’t shy away from a challenge.

Find out more about the great works of Texas’ Immunization Partnership  by visiting www.immunizeUSA.org/blog

Join us next week as we present a guest blog from a physician colleague from California on the #NIAM16 topic of Pregnancy

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