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

The journal 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 immunization 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 pneumococcal (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 vaccine (Zostavax).

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 reimburse pharmacies for administration of both vaccines.

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


Reference

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