Legislation Introduced to Increase Access to Shingles, Tdap Vaccines

A bill aimed at improving access to all recommended vaccines for Medicare beneficiaries, was introduced earlier this month by US Senators Mazie K. Hirono of Hawaiʻi, Shelley Moore Capito (R-W.Va.), and Sheldon Whitehouse (D-R.I.).

S. 1872, the Protecting Seniors through Immunizations Act of 2019, features improved access to vaccines for shingles and tetanus, diphtheria, and pertussis (Tdap), with the goal of helping to increase vaccination rates.

“No one should be denied access to critically-important vaccines because they cannot afford them,” Senator Hirono said. “Preventative measures such as vaccines are a cost-effective way to protect our kupuna against serious illnesses and diseases, such as shingles.”

“While we often think of vaccines as something we get as children, more than 50,000 adults die from vaccine-preventable diseases each year,” Senator Capito said. “The Protecting Seniors through Immunizations Act of 2019 will help to increase awareness about recommended vaccines and reduce the financial hurdles – including high-cost sharing, which prevents too many seniors from this cost-effective means of reducing disease and saving lives.”

“Too many older adults on Medicare have to weigh the health benefits of getting immunized against shingles or tetanus with the hefty out-of-pocket cost of these vaccines,” Senator Whitehouse said. “Our bipartisan legislation will keep older adults healthier by making commonly recommended vaccines available to Medicare beneficiaries at no additional cost to them.”

“On behalf of more than 55 organizations representing vaccine innovators, medical providers, and public health officials, members of the Adult Vaccine Access Coalition are proud to endorse the Protecting Seniors Through Immunization Act of 2019 and applaud the leadership of Senators Hirono, Capito and Whitehouse,” Patricia D’Antonio, Co-Chair of AVAC, said. “This important bipartisan bill will not only eliminate out-of-pocket costs for vaccines covered under Medicare Part D, but will also ensure that beneficiaries receive important information about the benefits of immunizations. With more than 50,000 adults dying from vaccine-preventable diseases every year, we can’t wait another minute.”

Advocates say vaccines play an essential role in preventing disease, helping to keep older adults active and independent, while also providing protection for vulnerable members of their families and communities, such as infants or others with suppressed immune systems.

Immunization coverage varies by vaccine under Medicare. Some immunizations – such as the flu, hepatitis B, and pneumococcal vaccines – are covered under Medicare Part B and available without additional out-of-pocket spending. Vaccines covered under Medicare Part D, including the shingles and Tdap vaccines, often require significant beneficiary cost-sharing, which in turn contributes to low uptake.

Vaccination rates remain low for both Tdap and shingles, and a 2018 study showed that higher out-of-pocket spending for these two vaccines was associated with higher rates of cancelled vaccinations, suggesting cost was a barrier. In the study, if beneficiaries faced out-of-pocket spending of more than $50, they were 2 to 2.7 times more likely to cancel the vaccination, compared with $0 cost-sharing.

Senators supporting the legislation say the Protecting Seniors through Immunization Act would:

• Reduce financial barriers by providing Medicare coverage of adult vaccines recommended by the Advisory Committee on Immunization Practices with no additional cost-sharing for beneficiaries. This would apply immediately to shingles and Tdap, and would apply to new vaccines as they are approved, like the anticipated vaccines against respiratory syncytial virus and clostridium difficile;
• Improve patient education by including in the Medicare & You Handbook information about coverage of vaccines; and
• Require a study on the uptake of vaccines among Medicare beneficiaries.