Adult Immunization Quality Landscape Presents Opportunities, Challenges


Even before the COVID-19 pandemic, vaccine hesitancy has been a challenge among adult patient populations.

Although there are many barriers and gaps in care within the adult immunization population, there is significant potential for improvement through new resources and improved data sources, according to a session presented at the 2022 Pharmacy Quality Alliance Annual Meeting.

Donna Dugan, PhD, MS, senior vice president at Discern Health, discussed the common barriers that arise when it comes to adult immunizations. Even before the COVID-19 pandemic, vaccine hesitancy has been a challenge among adult patient populations. Additionally, there have been challenges with inconsistent data, out of pocket costs, adult interaction with the health care system, and a low priority among providers for this group, according to the presentation.

Further, the setting of the immunization route has undergone a significant shift from clinician offices to pharmacies and skilled nursing facilities, which Dugan feels is important to address.

“Everyone was hearing about the importance of adult immunizations and the awareness of vaccine hesitancy, but understanding these new barriers, specifically from COVID-19, is very relevant to the immunization landscape,” Dugan said.

Chad Worz, PharmD, BCGP, executive director and chief executive officer at the American Society of Consultant Pharmacists, discussed specifically how long-term care (LTC) settings are generally not well understood by the government. Further, nursing facilities that were responsible for giving vaccines at home did not want to do it anymore after COVID-19 began.

Administrating immunizations in LTC settings is usually straightforward, in which the patient in need is identified, the immunization is administered, and then it is reported. However, there are still barriers in this process, as well, including the pharmacist burden and staff shortage, inadequate reimbursement, and low patient interest, according to Worz.

He mentioned that although there are resources available to help provide education on reimbursement and immunization delivery, it truly comes down to the conversations that need to be had with the government for further assistance.

“Having those conversations with the government about these data sources becomes important because then I can articulate specifically what population I am taking care of,” Worz said.

There are all different programs available on the payment end of the federal level, with many focusing on influenza and pneumococcal vaccines, but there is a continued lack of value-based pharmacy performance programs at this level, according to Brett Kay, director of Healthcare Quality Strategy at Johnson and Johnson. The challenges that have opened from this include data accuracy, identifying and tracking attributed populations, state variability in Immunization Information Systems reporting requirements, bidirectional capabilities, and a lack of pharmacist-directed incentives.

Kay explained that for our current state of siloed immunization delivery and inconsistent measure data sources to go away, we need to focus on initiatives such as incorporating new vaccines into quality measures and fully integrating pharmacists into value-based immunization delivery approaches.


Adult Immunization Quality Landscape Opportunities and Challenges. PQA 2022. May 5, 2022. Accessed May 5, 2022.

Recent Videos
Image credit:  Gorodenkoff |
Pharmacist and Patient in Pharmacy | Image Credit: Gorodenkoff -
Sun Screen, Photosensitivity, Pharmacy | Image Credit: sosiukin -
Catalyst Trial, Diabetes, Hypertension | Image Credit: grinny -
Image Credit: © Anastasiia -
Various healthy foods -- Image credit: New Africa |