Using life moments to strengthen adult vaccination
FRANKFORT A 65-year-old woman with a history of asthma and hypertension presents for a routine medication refill. As the visit is wrapping up, she shares that she is expecting her first grandchild in three months and will be providing regular childcare. She wants to make sure she stays healthy so she can be there for her grandchild.
It is a moment many clinicians recognize. A routine visit suddenly becomes personal. It also becomes an opening to talk about prevention in a way that feels relevant to the patient in front of you.
A review of her immunization history shows that her last Tdap (tetanus, diphtheria and pertussis) vaccination was many years ago. She receives influenza and COVID-19 vaccines each fall but has never received shingles or RSV vaccines. Her pneumococcal vaccination status is unclear, and she is unsure of her measles immunity. This scenario is common. Many adults do not have a clear sense of what being “up to date” means once childhood vaccines are behind them.
The Boxes We Check and the Ones We Miss
In a typical adult visit, we move quickly through the checklist. Lipid panel, check. A1c, check. Blood pressure, check. Cancer screening, check. The visit ends, the plan is in place. But are we checking all the boxes? What about pneumococcal, RSV, and Tdap vaccines?
Adult preventive care is often framed around chronic disease management and screening. Vaccination belongs in that same preventive framework. While many clinicians feel comfortable asking about influenza vaccination, that same moment can be used to review other recommended adult vaccines. Asking patients if they are “up to date” often leads to uncertainty. Providing patients with specific, targeted recommendations can help increase vaccine confidence and uptake. Adult immunization schedules published by professional organizations, including the American Academy of Family Physicians, provide practical, quick reference tools clinicians can use during routine visits.
What the Numbers Show in Kentucky (65+)
Kentucky Immunization Registry (KYIR) data from 2024 show that vaccination coverage among adults age 65 and older remains below optimal levels for several routinely recommended adult vaccines.
- Pneumococcal (65+, at least one dose): 52.06%
- Tdap (65+, at least one dose): 38.10%
- Influenza (65+): 56%
- COVID-19 (65+): 33%
- RSV (65+): 22%
These gaps reflect missed opportunities to vaccinate adults who are eligible for recommended vaccines but have not yet received them. Lower adult vaccination coverage contributes to preventable illness, adds strain to health care systems during respiratory season, and increases the risk of transmission to people who are more vulnerable, including infants who depend on the immunity of the adults around them. As newer adult vaccines such as RSV are introduced and early uptake remains modest, making adult vaccination part of routine clinical conversations helps ensure more adults are protected.
Source: Kentucky Immunization Registry – HEALTHTRACKING
A Practical Plan for the New Grandparent
Seeing these gaps locally makes the need for a focused, visit-based approach clear. A simple, staged plan allows clinicians to address the most time-sensitive vaccines before delivery while spacing out others across follow-up visits to avoid overloading patients in a single encounter.
Putting It into Practice
Adult vaccination is not solely the responsibility of the primary care provider. Many adults see specialists more often than they see general practitioners. When vaccination is assumed to be addressed elsewhere, it is often missed. Every clinical encounter represents an opportunity to identify gaps and reinforce prevention.
Simple steps like building immunization review into pre-visit workflows, the same way medications are reviewed, help normalize vaccine conversations. Many electronic medical records already include immunization prompts or health maintenance tools within visit templates. Using these built-in reminders keeps adult immunization visible during routine visits and reduces missed opportunities across care settings.
Every Visit Is an Opportunity
Whether a patient is preparing to become a grandparent, planning a long anticipated international trip, or simply coming in for routine bloodwork, each of these moments is an opportunity to talk about prevention. Travel planning often raises questions patients may not realize they need to ask. Many are unaware that certain destinations carry specific health risks or that additional vaccines may be recommended based on where they are going. Having travel clinic information readily available allows clinicians to connect patients with destination-specific guidance and shows patients that their broader health goals are being heard. For some patients, this may be the first time a provider has ever raised the topic of travel-related vaccines.
Why These Conversations Matter
Many of the adults we care for today have spent years caring for children, parents and communities. Taking a few moments to address adult vaccination during routine visits is one small way we can return that care. These everyday conversations help support healthier aging and protect the people our patients continue to show up for.
Additional Resources
Immunization Outreach
Cabinet for Health and Family Services
https://chfs.ky.gov/agencies/dph/dehp/idb/Pages/default.aspx
Kentucky Immunization Registry (KYIR)
Cabinet for Health and Family Services
https://www.chfs.ky.gov/agencies/dph/dehp/idb/Pages/kyir.aspx
American Academy of Family Physicians
Adult immunization schedule and clinical guidance for routine visits
https://www.aafp.org/family-physician/patient-care/prevention-wellness/immunizations-vaccines/immunization-schedules/adult-immunization-schedule.html
Immunize.org
Clinical vaccine guidance, patient education materials and immunization tools for health care professionals
https://www.immunize.org
Vaccine Integrity Project
Independent research and analysis on vaccine policy, public trust, and vaccine systems
https://vaxintegrity.cidrap.umn.edu/
Daphne Spalding, BSN, RN, is clinical support section manager for the Immunization Branch at the Kentucky Department for Public Health. With 28 years of nursing experience, she now leads statewide immunization guidance, supporting providers and the public with clear, accurate vaccine information. Please contact the Kentucky Department for Public Health at immunizationbranch@ky.gov with any questions.