Introduction
Dear Editor,
Home healthcare services provide essential medical care through mobile health teams to individuals who are bedridden or unable to access healthcare facilities due to chronic conditions. Despite their importance, adult immunization has not been systematically prioritized within this care framework.
Adult immunization rates in Türkiye are known to be low, and globally, adult vaccination coverage remains suboptimal compared to recommended targets.[1,2] Patients receiving home healthcare represent a particularly high-risk group, as they often encounter significant barriers to accessing vaccines.[3] Home visits thus constitute a critical and underutilized opportunity to evaluate vaccination status and address gaps in coverage. The COVID-19 pandemic demonstrated the feasibility of home-based vaccination through successful administration of COVID-19 vaccines in this population.
Family physicians, who are entrusted with the mission of preventive health care, have sought to integrate immunization into home visits to reduce disease burden and enhance cost-effectiveness within the health system. At the Family Medicine Clinic of Istanbul Prof. Dr. Cemil Taşcıoğlu City Hospital, we pioneered home-based vaccination by systematically reviewing patient vaccination status using the ATS (National Vaccine Tracking System) and the national e-Nabız platform. Pneumococcal and influenza vaccines were subsequently administered to eligible high-risk individuals.
To expand this initiative across Istanbul, the Istanbul Provincial Directorate of Health convened a meeting on July 31, 2024, under the leadership of Prof. Dr. Güzin Zeren Öztürk and Prof. Dr. Seçil Arıca, focusing on safe immunization practices in home healthcare. This meeting provided practical guidance for healthcare teams and promoted multidisciplinary collaboration through regular training and knowledge-sharing. Consequently, approximately 2,000 high-risk patients receiving home healthcare services in Istanbul were vaccinated in their homes with pneumococcal and influenza vaccines, following informed consent.
The main challenges encountered included vaccine hesitancy among patients and caregivers, as well as logistical constraints. These barriers, however, were largely mitigated through targeted communication and effective coordination within care teams.
Looking ahead, sustaining and scaling adult immunization in home healthcare services will require strengthening regulatory frameworks, expanding education and training programs, and enhancing monitoring systems at both local and national levels. Such efforts are essential to fully realize the preventive potential of home healthcare as a platform for improving adult vaccination coverage.
Sincerely,
Source of funding
The authors declare the study received no funding.
Conflict of interest
The authors declare that there is no conflict of interest.
References
- Republic of Türkiye, Ministry of Health. National immunization program report. Ankara: Ministry of Health; 2023.
- Centers for Disease Control and Prevention (CDC). Recommended adult immunization schedule, United States, 2024. Atlanta (GA): CDC; 2024.
- World Health Organization (WHO). Immunization in older adults. Geneva: World Health Organization; 2023.
Copyright and license
Copyright © 2025 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.
