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The Centers for Disease Control and Prevention (CDC) estimates that every year in the United States, on average, 5% to 20% of the population is infected with the influenza virus; >200,000 individuals are hospitalized from flu complications; and 36,000 patients die from the flu. The CDC has designated the week of December 8 to 14 as National Influenza Vaccination Week to highlight the importance of continuing the flu vaccine.
For the 2008-2009 flu season, vaccine manufacturers project that between 143 million to 146 million doses of the influenza vaccine will be available. The FDA recently approved 6 flu vaccines for this influenza season. The flu vaccine is recommended for individuals aged 50 and over, pregnant women, individuals with chronic medical conditions, nursing home or long-term care residents, and individuals who live or care for those at high risk for complications from the flu. The 2008-2009 flu season marks the first time all healthy children aged 6 months up to their 19th birthday are recommended to get the vaccine.
The CDC also recommends that adults aged 60 and older be vaccinated with Zostavax (Zoster Vaccine Live [Oka/ Merck & Company Inc]) to prevent herpes zoster, commonly known as shingles. Zostavax is the only vaccine to prevent herpes zoster.
As the most accessible health care providers, pharmacists are in a unique position to advocate the importance of vaccinations. In addition, many independent and chain pharmacies offer vaccination services and annual flu programs.
The National Community Pharmacists Association's (NCPA) 2007 NCPA-Pfizer Digest found that 43% of independent community pharmacists offer immunizations. The association expects that number to hold steady as it collects data for the 2008 publication.
Katterman's Sand Point Pharmacy in Seattle, Waghington, is an "immunization destination," according to co-owner Beverly Schaefer, RPh. The pharmacy provides all vaccines available, including seasonal flu, FluMist, and pneumonia immunizations.
Shaefer explained that the pharmacy has a year-round immunization business that includes routine immunizations, such as hepatitis A, hepatitis B, polio, human papillomavirus (HPV), meningococcal, chickenpox, and shingles. In addition, it offers travel immunizations like typhoid, yellow fever, and Japanese encephalitis.
"All immunizations are administered by a pharmacist and all are available on a walk-in basis without an appointment and without a doctor's prescription. Washington State allows us to have a collaborative practice agreement with a local physician that gives us prescriptive authority for all vaccines," she said.
When the pharmacy administers the vaccine, with the exception of the flu, it sends a fax to the patient's primary care physician, so immunizations can be recorded in the patient's medical record. It also serves as a reminder for physicians on where they can refer patients for immunizations not routinely offered in doctor's offices.
Katterman's does about 3000 flu shots annually and offers the service from October through May. No appointment is necessary, walk-ins are welcome, no prescription is required, and shots are available when the pharmacy is open. When the pharmacy began offering the flu vaccine in 1996, it was one of the first pharmacies to offer large-scale immunizations. "We did 1200 flu shots our first year. We were successful and profitable beyond our wildest expectations," said Shaefer.
The pharmacy also offers the Zostavax vaccine. The vaccine has been offered since it received FDA approval in May 2006, and the pharmacy has done >500 immunizations. The pharmacy can administer both the flu and Zostavax vaccines at the same time if they are available.
"In addition to increasing access to medical services, offering immunizations is profitable for pharmacies. Immunizations are now more than 10% of our pharmacy business," she said. "It takes about the same amount of time as filling a new prescription. It increases foot traffic in the pharmacy. Many people seeking immunizations buy other products or prescriptions (often in the case of travel immunizations). It allows the pharmacist to be a source of health information for both patients and physicians year-round."
In 2000, the SUPERVALU Adult Immunization program was established to help provide the communities the store serves with convenient access to preventive health care. Specially trained and certified SUPERVALU pharmacists can administer the Zostavax vaccine by appointment in many of the pharmacies year-round, reported Jeff Bregar, RPh, manager of the Adult Immunization Program. To date, the pharmacies have "administered >15,000 doses and educated thousands of patients about the Zostavax immunization, as well as available insurance options to help them make wise and healthy choices," he said. The vaccine is covered by Medicare Part D, Medicare Advantage, and other insurance providers. The pharmacy also provides a range of adult vaccines.
SUPERVALU has been offering flu clinics for >10 years. Immunizing pharmacists will provide traditional flu shots and the no-needle FluMist nasal spray vaccine by appointment or on a walkin basis at in-store pharmacies through February. Both vaccines also will be offered at special, in-store flu vaccine clinics through December. In addition to providing flu vaccines at each of its 920 in-store pharmacies, it will offer nearly 3000 flu clinics nationwide, said Bregar.
The cost for the flu shot is $24.99, and Medicare Part B, Medicare Advantage, and other insurance plans are accepted. To minimize wait times, individuals are encouraged to make an appointment. Appointments are not required for the walk-in flu clinics, where patients are seen on a first-come, first-served basis. For more information, patients can call 800-783-0458 (Jewel Osco patients can call 866-388-1805) to schedule an appointment and find a nearby location; visit the in-store pharmacy to make an appointment or ask questions; or visit healthprograms.supervalu.com and click on the "Health Programs Locator."
Publix offers the Zostavax vaccine in its Alabama, Tennessee, South Carolina, and Georgia locations with a prescription. Patients should contact their Publix pharmacist for the schedule. Publix also offers the pneumococcal, tetanus and diphtheria (TD), and tetanus, diphtheria, and pertussis (TDaP) vaccines.
For >6 years, Publix has been offering the flu shot program, which runs through December 15. The cost for the flu shot is $30, and Medicare Part B is accepted for the influenza and pneumococcal shots. The other immunizations are cash only. Many locations will offer walk-ins or appointments. Patients can find more information by visiting www.publix.com/flu, by calling 877-629-3580, or by speaking with a Publix pharmacist.
Rite has been offering the Zostavax vaccine for 4 years. The vaccine is administered by pharmacists in states where permitted and according to state regulations. Cost varies depending on insurance. Normally appointments are not needed, but since this vaccine in is high demand and orders take a few weeks, appointments are recommended. Other vaccination services include pneumococcal, meningococcal, hepatitis A, hepatitis B, HPV, and TDaP.
The pharmacy chain will host a 3-day flu and pneumonia shot clinic this month. Patients also can receive flu shots from any of its 1200 immunizing pharmacists through the season by appointment. In addition, the flu shot will be available at Rite Aid stores that host in-store clinics from its clinic partners. Nearly 2600 flu shot clinic events will be held this fall at 1300 stores.
The cost for the flu shot is $30, free for patients with Medicare Part B, and some private insurance plans are accepted. The vaccine will be administered on a first-come, first-served basis at the flu clinics. At locations with an immunizing pharmacist, patients will need to make an appointment. Patients can find out more information by visiting www.riteaid.com, speaking with a pharmacist, or calling 866-751-1494.
CVS does not administer the Zostavax vaccine. If a patient has a prescription for the vaccine, the pharmacy will transfer the prescription to its specialty mail-order unit, which will coordinate schedules with the patient and the physician and ship the drug directly to the physician for administration of the vaccine to the patient. Additional vaccination services administered by nurse practitioners at CVS MinuteClinics include TD, pneumococcal, and polio.
CVS, which has been offering flu clinics for >10 years, will have store clinics operating until the end of this month. Flu shots at MinuteClinics will be available the entire flu season. A total of 7500 flu clinics will be held in CVS/pharmacy locations. Scheduled clinics will operate on a first-come, first-served basis. In addition, flu shots will be available on a walk-in basis, no appointment necessary, at CVS/pharmacy's 540 in-store MinuteClinic locations.
Each flu shot is $30. Medicare Part B recipients who have not reassigned their prescription coverage benefits to an HMO may get the flu shot at no cost when they present their Medicare Part B card. Patients can find out more information by calling 888-FLU-SHOT or visiting www.cvs.com and clicking on the store finder link. All stores hosting clinics also will have flu clinic schedules posted.
Walgreens has been offering flu shot clinics for >12 years. For the first time, most Walgreens locations also will offer the FluMist nasal spray as an alternative to the shot. In addition to Walgreens pharmacies, patients can receive the flu vaccine at all 237 Take Care Clinics. Board-certified nurse practitioners and physician assistants will administer the shots and nasal spray.
The cost for the flu shot is $24.99 at most Walgreens locations, and the nasal spray is $29.99. Medicare Part B is accepted, and the vaccinations may be covered by insurance plans. Patients are encouraged to check with their insurance provider. Appointments are recommended at Walgreens pharmacies. Take Care Clinics will offer the vaccine 7 days a week with no appointment required. Patients can find additional information by calling 800-FLU-9950 or visiting www.walgreens.com/flu and www.TakeCareHealth.com.
Kmart Pharmacy will operate flu clinics through November 13. The vaccine will be offered at >900 pharmacist-based and 400 nurse-based clinics and nonpharmacy locations throughout the country. Flu shots at the pharmacy are $25 and pneumonia shots are $50. Patients can find out more information by visiting www.kmart.com, calling 800-822-8345, or asking a Kmart pharmacist.
Whereas Wal-Mart pharmacists will not administer the flu immunization, nurses will be available to administer the vaccine in some pharmacies and Sam's Clubs. The flu shot program runs through November 8.
The cost for the flu shot is $29 and will be conducted on a first-come, first-served basis. Patients can find more information from in-store signage or by visiting www.flushotusa.com/walmart.