Danielle McPherson, PharmD Candidate

The CDC has declared immunizations one of the greatest health achievements of the 20th century, but vaccination rates among adults remain suboptimal.

Research in Social and Administrative Pharmacy

 published a 6-month randomized controlled trial in which pharmacist-technician pairs at 62 pharmacies in Alabama and California completed the “We Immunize Program” training. The findings showed that practical, evidence-based strategies training combined with monthly expert feedback enhanced pneumococcal 

services more than herpes zoster vaccine administration.

Investigators found that only 23% of high-risk adults under age 65 years and 63.6% of adults over age 65 years received the recommended 

 (PPSV23 or PCV13), during the 2-year study period ending in 2017. Similarly, only 30.6% of adults ages 60 years or older received the shingles 

Barriers for increased herpes zoster immunization services include the requirement for a physician’s prescription in certain states and the need for adequate freezer storage space. Costs incurred by the patient should not hinder availability because Medicare part B and D 

These results may also reflect a lack of pharmacist knowledge about patient eligibility and proper administration recommendations, which illustrates the continued need for proper education.

In 2013, only 77% of pharmacists offered pneumococcal vaccines and 75% offered herpes zoster vaccines. To increase accessibility, creation of immunization service structures and budget development at the corporate-level would promote leadership involvement and concurrent accountability.

Since the end of the study period, the FDA licensed the recombinant zoster vaccine (Shingrix). It is now preferred over Zostavax in adults older than age 50 years. Use of this vaccine in future studies also eliminates constraints of physical freezer storage space as a barrier to vaccine availability.

Community pharmacies are positioned well to determine patient eligibility and administer vaccinations given their convenient locations and extended business hours. With proper initiatives and training strategies, pharmacists can lead the change toward increasing vaccination rates and reducing preventable diseases.

 is a 2019 PharmD candidate at the University of Connecticut in Storrs, Connecticut.

Hohmann LA, Hastings TJ, Ha DR, et al. Impact of a multi-component immunization intervention on pneumococcal and herpes zoster vaccinations: A randomized controlled trial of community pharmacies in 2 states. 

. 2019 Feb 7. pii: S1551-7411(18)30747-2. doi: 10.1016/j.sapharm.2019.01.006. [Epub ahead of print]

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Pharmacist-Tech Teams Increase Immunization Rates in Elders

A survey of sexually active women in the United States revealed that 29% experienced challenges in obtaining either a prescription or a refill for hormonal contraception. As medication experts and highly trusted professionals, pharmacists can help decrease patient barriers to adherence in the community-based pharmacy setting.

has published a study showing that pharmacists in California and Oregon are serving as an access point for hormonal contraception services and supplies for diverse patient populations. The descriptive study included 391 community-based pharmacies in which a total of 2117 visits were completed over a 6-month period.

During this time, pharmacists who had completed standardized training wrote and dispensed 1970 hormonal contraceptive prescriptions. Of the 2117 visits, 93% of patients received hormonal contraception; the remaining 7% were referred to their PCPs, most commonly due to elevated blood pressure, which is a contraindication to receiving the medication.

Although health care insurance reimbursement was not available during the study, the Medicaid programs in each respective state implemented billing for pharmacy services shortly after. Patients paid an out-of-pocket flat service fee and pharmacists billed contraceptive services to the patient’s insurance. However, pharmacist reimbursement remains a nationwide barrier for implementing new pharmacy services.

The majority of prescriptions were issued to adults aged in their mid-twenties for a full year’s supply of either the combination or progestin-only contraception pill. In previous studies, women who received a 12-month supply of oral contraceptives showed increased adherence and a 30% reduction in unintended pregnancies in comparison to those who received a 1-month or 3-month supply.

With this in mind, expanding pharmacists’ scope of practice at the state level to include prescribing self-administered hormonal contraception may concurrently increase patient adherence and decrease unintended pregnancies.

Since closure of the study period, statewide protocols for pharmacist prescribing has grown to include Colorado, Hawaii, Maryland, and New Mexico.

is a 2019 PharmD Candidate at the University of Connecticut in Storrs, Connecticut.

Lu S, Rafie S, Hamper J, Strauss R, Kroon L. Characterizing pharmacist-prescribed hormonal contraception services and users in California and Oregon pharmacies. 

. 2018 Dec 16. pii: S0010-7824(18)30525-0. doi: 10.1016/j.contraception.2018.12.002. [Epub ahead of print]

A survey of sexually active women in the United States revealed that 29% experienced challenges in obtaining either a prescription or a refill for hormonal contraception.