As Measles Cases Surge, Pharmacists Are Stepping Up to Close the Vaccination Gap

In 2023, measles infected 59 patients in the US. In 2026, cases have risen to 2134—a 36-fold increase—only 6 months into the year (Figure 1).¹

Furthermore, childhood vaccination rates have dropped since the start of the COVID-19 pandemic in spring 2020. Increased public skepticism has contributed to many school-age children being un- or undervaccinated. From 2019 to 2025, vaccination coverage for diphtheria, tetanus, and acellular pertussis; measles, mumps, and rubella; and polio vaccines dropped 3% nationally.² Although a 3% decline seems small, undervaccination has put more than 300,000 of the nation’s 10.5 million children aged 5 to 7 years at a heightened risk for contracting preventable diseases since the 2019 school year.³

However, this does not tell the whole story. Although some states have maintained high vaccination rates, high state-to-state variability remains. Figure 2² illustrates the substantial state-level variation in childhood vaccination coverage, with Kentucky experiencing approximately a 7% decline. This paradigm shift coincides with increased hospitalizations; when examining measles alone, 136 of the 2134 confirmed cases in 2026 led to hospitalizations. Hospitalizations often lead to worse patient outcomes and cost patients far more than the vaccines that help prevent them.^1,2

A Brief History of Vaccination Programs

To combat declining vaccination rates, pharmacists have become vaccination stewards in their communities. As early as 1994, pharmacists began training to administer vaccines; by 2009, all 50 states had adopted laws or regulations authorizing pharmacists to do so.⁴ As the need for vaccinations rose to an all-time high in 2020 during the COVID-19 pandemic, the nation looked to pharmacists to shoulder most of the vaccination burden.

In 2020, the US Secretary of Health and Human Services amended the Public Readiness and Emergency Preparedness (PREP) Act. The amendment temporarily authorized trained pharmacists and pharmacy technicians to administer COVID-19 and influenza vaccines to patients 3 years and older.⁵ The act established federal preemption over conflicting state requirements during the public health crisis.

The Evolving Role of Community Pharmacies

Over the course of the pandemic, pharmacists and pharmacy technicians administered more than 50% of all COVID-19 vaccines.⁴ Between August 2025 and April 2026, community pharmacies administered 20.7 million COVID-19 and 36.4 million other vaccines throughout the country.^6,7 The PREP Act benefited the nation so much that Congress extended the act until December 31, 2029.

Community pharmacies have become an increasingly common site for vaccine administration. Scheduling appointments at primary care offices has become increasingly difficult, but pharmacies are embedded in the community and offer a more accessible route for vaccinations. Since 2020, pharmacies have been responsible for the majority of vaccine claims per 100,000 patients, with the percentage skyrocketing to more than 80% of claims in 2022.⁸

Pharmacists’ Impact on Vaccine Adherence

At the same time, pharmacists actively dispel vaccine myths and educate patients on the benefits of maintaining vaccine adherence, especially in underserved communities. A 2026 meta-analysis investigated the impact of pharmacist counseling and direct vaccine administration in high-risk patients.⁹ The analysis examined 1.3 million patients across 35 studies throughout the US. Pharmacy-led interventions included administration, counseling, and eligibility assessments for other vaccines. The high-risk patients consisted of those 65 years and older, those aged 18 to 64 years with chronic conditions, and those with limited access to health care.

The data compared patients who received an intervention from a pharmacist with patients who did not. Patients who received the intervention at the time of care were nearly 5 times more likely to become vaccinated (OR, 4.87; 95% CI, 2.23-10.64). Higher vaccination coverage directly leads to decreased disease burden, hospitalization, and deaths—especially in these vulnerable populations—so pharmacists can directly impact their community by administering vaccines.

Although pharmacist advocacy for vaccines is beneficial, direct pharmacist immunizations are the most effective means to combat declining rates. A systematic review and meta-analysis of 17 randomized controlled trials examined whether pharmacist advocacy or direct immunization had a greater impact on vaccination services.¹⁰ Although both roles increased vaccination rates compared with no intervention, immunizing pharmacists increased vaccination rates by 76%, whereas pharmacist advocacy alone increased rates by 59%.

Whether pharmacists are directly administering a vaccine to a patient, identifying gaps in vaccination coverage, or facilitating insurance authorization, the bottom line is that any pharmacist involvement in the vaccination process is an immense benefit to patients’ lives.

Conclusion

In a world where misinformation becomes mainstream overnight, it is more important than ever to facilitate pharmacist vaccine counseling and administration. As medically educated conduits, pharmacists can set the record straight on the benefits vaccines serve society. With thousands of retail pharmacies dispersed throughout communities across the US, barriers to vaccine adherence have fallen drastically. Despite the increased workload, providing evidence-based patient education will continue to play a central role in preventing vaccine-preventable disease and improving public health nationwide.

About the Author

Ethan Nolin-Halpern is a 2027 PharmD candidate at the University of Connecticut in Storrs.

REFERENCES

1. Measles cases and outbreaks. CDC. Updated July 17, 2026. Accessed July 21, 2026. https://www.cdc.gov/measles/data-research/

2. Vaccination coverage and exemptions among kindergartners. CDC. Updated July 31, 2025. Accessed July 21, 2026. https://www.cdc.gov/schoolvaxview/data/?CDC_AAref_Val=https://www.cdc.gov/vaccines/imz-managers/coverage/schoolvaxview/data-reports/index.html

3. Enrollment in public elementary and secondary schools, by level, grade, and state or jurisdiction: fall 2022. National Center for Education Statistics. December 2023. Accessed July 21, 2026. https://nces.ed.gov/programs/digest/d23/tables/dt23_203.40.asp

4. Goode JR, Rothholz MC, Foster SL, Brody ER, Gräbenstein JD. Pharmacy-based immunization delivery: a comprehensive history and current challenges. J Am Coll Clin Pharm. 2026;9(6):e70219. doi:10.1002/jac5.70219

5. Pharmacist and pharmacy technician vaccination authority. National Alliance of State Pharmacy Associations. January 3, 2025. Accessed July 21, 2026. https://naspa.us/resource/2024-pharmacist-immunization-authority/

6. Influenza vaccinations administered in pharmacies and physician medical offices*, adults, United States. CDC. March 25, 2026. Accessed July 21, 2026. https://www.cdc.gov/fluvaxview/dashboard/adult-vaccinations-administered.html

7. COVID-19 vaccinations administered in pharmacies and medical offices*, adults 18 years and older, United States. CDC. March 25, 2026. Accessed July 21, 2026. https://www.cdc.gov/covidvaxview/weekly-dashboard/vaccinations-administered-pharmacies-medical.html

8. Trends in vaccine administration in the United States. IQVIA. January 13, 2023. Accessed July 21, 2026. https://www.iqvia.com/insights/the-iqvia-institute/reports-and-publications/reports/trends-in-vaccine-administration-in-the-united-states

9. Borlini S, Pennisi F, Pinto A, de Ponti E, D’Amelio AC, Signorelli C. Impact of pharmacy-based interventions on vaccination coverage among vulnerable and underserved populations: a systematic review and meta-analysis. Vaccine. 2026;78:128426. doi:10.1016/j.vaccine.2026.128426

10. Elganam Y, Kim EY. Impact of pharmacist intervention on enhancing vaccination coverage: a systematic review and meta-analysis. Res Social Adm Pharm. 2025;21(7):495-504. doi:10.1016/j.sapharm.2025.03.004