Vaccines save lives at a scale that is hard to overstate — the WHO’s Expanded Program on Immunization alone has prevented 154 million deaths since 1974. Yet despite this, adult influenza vaccination rates in the U.S. fell to just 44.9% in the 2023–2024 season, and nearly 30% of adult patients say they are unlikely to get the flu vaccine. Patients with chronic respiratory diseases, who face disproportionate risk from vaccine-preventable illness, are particularly underserved when pulmonary specialists deprioritize immunization as outside their scope of practice.
This editorial, published in the American Journal of Respiratory and Critical Care Medicine, makes the case for why pulmonologists must re-engage with disease prevention — and introduces the American Thoracic Society’s Vaccine Initiative as a vehicle for doing so. Funded through a collaboration with the CDC and the Council of Medical Specialty Societies, the initiative supports eight geographically and demographically diverse health systems in implementing quality improvement strategies to increase vaccination rates for influenza, pneumococcus, and COVID-19 among high-risk pulmonary patients. Each site uses implementation science frameworks to identify local barriers, develop targeted interventions, and share learnings that can be scaled nationally. The authors frame this as a return to the ATS’s founding mission — the organization’s predecessor, the American Sanatorium Association, was built around disease prevention — and argue that vaccination deserves the same clinical urgency as the technological advances that have come to define modern pulmonary medicine.