Despite strong federal and regulatory support for mandatory vaccinations among healthcare workers — including nursing home employees — the U.S. adult vaccination rate is on the low side, according to a new research brief.

Fewer than 70% of adults at the highest risk for influenza — or complications from influenza — were vaccinated as of 2009. And only 10% had been vaccinated against shingles, according to the RAND Corporation. As a result, care and other fallout for influenza and related illnesses are costly. Depending on the severity of the season, influenza can cost the economy up to $90 billion annually in lost productivity and healthcare spending, according to the brief.

Nursing home residents with compromised immune systems are routinely vaccinated for the flu, yet associations that represent nursing homes have stopped short of endorsing the idea of mandatory flu vaccinations for employees.

RAND experts urged employers to help physicians assess the needs for adult vaccinations; facilitate performance-based payments to providers that provide vaccinations; or formalize a protocol for referring patients for vaccination to outside provider offices. n