Every fall between Oct. 15 and Dec. 7, 48.7 million Americans sit down at their kitchen tables to decide which Medicare prescription drug plan (Part D) they should choose to cover their medications. More than 213,329 of our fellow Hawaii residents are among them. For many, it is an agonizing process because of the complicated and costly landscape. Starting Jan. 1, 2023, there will be one less cost to worry about: vaccines under Medicare will be free of cost.

I welcome this change. As a geriatrician, unfortunately, far too often I see seniors decide not to get vaccinated because of a high copay that their Medicare Part D health plans require for vaccinations.

Every year, thousands of adults die and thousands more suffer serious health problems from vaccine-preventable diseases like the flu, pneumonia, shingles, and tetanus, diphtheria and pertussis (or whooping cough).

While Medicare Part B covers vaccinations to protect against influenza, pneumococcus and hepatitis B at no cost, Medicare Part D covers all other CDC-recommended vaccines, including those for shingles (Zoster), whooping cough (Tdap), and until now, they were costing beneficiaries as much as $160 a shot.

Research shows that when Americans must pay for their vaccines, they are less likely to be vaccinated. Nationwide, 70% of adults 65 years and older get vaccinated for flu (free under Medicare Part B) while only 37% get a shingles vaccine (with copay under Medicare Part D). Yet almost 1 out of every 3 people in the U.S. will develop shingles — a painful and potentially disabling skin rash caused by the same virus that causes chickenpox.

The vast majority of my time is spent on research and treatment of afflictions associated with aging. Many people don’t realize that vaccines are especially important for older adults because a healthy person’s ability to fight off infection weakens over time. Adults aged 50 and over are particularly susceptible to vaccine-preventable disease, and they account for a disproportionate number of serious illnesses and deaths. Copays and coinsurance on vaccines not only place an unnecessary financial burden on those living with fixed incomes but also put the health of millions of Americans needlessly at risk.

By removing these cost barriers, more than 200,000 Medicare Part D recipients in Hawaii alone will have a greater opportunity to avoid getting sick or dying from diseases that a simple — and free — shot could prevent. Our economy could get a boost, too: not only will adults be protected from significant health care expenses associated with these diseases, but the U.S. could also save billions in treatment costs.

It’s taken years to get here with tireless efforts from so many, including Hawaii’s U.S. Sen. Mazie Hirono, who supported provisions in the Protecting Seniors Through Immunization Act passed recently as part of the Inflation Reduction Act. Thanks to this persistence, my patients do not have to decide between good preventive health or paying for their basic living needs.

But there’s still work to do. Ensuring that our seniors in Hawaii have affordable access to these life-saving vaccines is one step in ensuring that our state’s most vulnerable are also among the most protected. We also have a responsibility to make sure that people know about this new benefit: physicians need to share this important news with their patients and be prepared for an increase in demand; health insurance plans and public health officials need to launch information campaigns across our state.

The COVID-19 pandemic has done much to expose and exacerbate the health disparities facing millions of Americans, but it also showed the undeniable benefits of a no-cost immunization campaign.

Our country’s health depends on all of us doing our part to curtail the spread of vaccine-preventable diseases and mortality. This is an investment in the future health, well-being, and economic security for all of us as we age.

Bradley Willcox, MD is Professor and Director of Research at the University of Hawaii’s Department of Geriatric Medicine and author of a New York Times best-selling book on healthy aging.