A shot in the arm.

• Position: STATESTATS

It's flu season, and even though H1N1 is no longer at pandemic levels, it's still important to get a flu shot every year (which includes H1N1 and two other flu strains this year). Other adult vaccines, such as pneumonia and shingles, also are important. Each year, approximately 23,000 Americans die of the seasonal flu, 5,000 die from pneumonia, and more than 1 million adults get shingles, a painful rash caused by the same virus that causes chickenpox. Direct health care costs of adult vaccine-preventable diseases are $10 billion annually according to the Centers for Disease Control and Prevention.

Yet only 36.1 percent of adults are vaccinated each year for the seasonal flu (recommended now for everyone over six months old), only 66.9 percent of seniors get the pneumococcal vaccine (recommended once for adults age 65 and older), and only 2 percent are vaccinated for shingles (recommended for everyone over 60), according to a report by the Trust for America's Health, the Infectious Diseases Society of America, and the Robert Wood Johnson Foundation. The CDC recommends flu vaccinations for all healthcare workers.

Immunizations are one of the most cost-effective ways to protect individual and public health, but little public health infrastructure exists to support mass vaccination of adults. In August, federal authorities announced a $1.9 billion plan to identify and manufacture drugs and vaccines for public health emergencies with the goal of shaving weeks off the time it takes to identify promising scientific discoveries, produce vaccines and get them to market.

POLICY OPTIONS TO INCREASE ADULT VACCINATION RATES

* Require insurers (including Medicaid) to cover vaccine costs for all 10 adult vaccines...