Integrate Open Conversations About Flu Vaccines Into MTM Consults

Influenza vaccines are on their way to pharmacies across the US for the 2026 to 2027 season. Approximately 90% of patients in the US live within 5 miles of a community pharmacy, making pharmacists one of the most accessible health care professionals to visit for a vaccine.¹ Approximately 46% of individuals 18 years and older received an influenza vaccine during the 2025 to 2026 flu season as of February 22, 2026.² Immunization rates have declined, partly due to misinformation, but pharmacists can integrate open conversations about flu vaccines during medication therapy management (MTM) consults.

Influenza Vaccines and MTM

Pharmacists can initiate conversations in person or virtually via telephone. When patients are picking up their medications at the pharmacy, it is a perfect time to initiate these discussions. Motivational interviewing is an important tool in the pharmacist’s toolbox for encouraging influenza vaccination, especially amid increasing vaccine hesitancy. It is a patient-centered approach that involves open communication to explore patient beliefs and determine knowledge gaps. Evidence shows motivational interviewing can be an effective way to communicate with vaccine-hesitant patients.³

One study evaluated the Motivational Interviewing Tool to Improve Vaccine Acceptance (MOTIVE) tool for pharmacists to identify and manage vaccine hesitancy. Pharmacists who completed training for the program in 8 Midwestern pharmacies participated in the study. Four training modules were developed for initiating vaccine conversations. These were online self-paced learning modules that included an overview of motivational interviewing, vaccine hesitancy and health beliefs, MOTIVE tools, and patient case studies for pharmacists to apply these skills in practice.³

Pharmacists, pharmacy interns, and pharmacy technicians who interacted with patients about immunizations completed the training program. There was a total of 362 encounters with patients who expressed vaccine hesitancy across 8 community pharmacy and ambulatory care settings. Approximately 35% of the vaccines addressed were influenza. Top reasons for vaccine hesitancy included safety, care coordination, and efficacy concerns. After the pharmacist encounter, approximately 61% of patients either received a vaccine or planned to receive one in the future.³ These study findings highlight the important role pharmacists can play through motivational interviewing to improve vaccine acceptance.

It is particularly vital to educate adults 65 years and older about influenza vaccine options during MTM consults.⁴ These include high-dose inactivated and recombinant or adjuvanted vaccines. Fluzone High-Dose (Sanofi), Fluad (CSL Seqirus), and Flublok (Sanofi) are options to recommend for individuals 65 and older because they are the most effective for this age group.⁴ This patient population should not receive the FluMist nasal spray (AstraZeneca) because it is a live vaccine that is not effective in this age group.⁵

Timing is also critical, so pharmacists can recommend that patients receive their annual influenza vaccine in September or October. Pharmacists can educate patients that it takes approximately 2 weeks after vaccination to build up antibodies against influenza.⁶ 

Pharmacists also play a vital role in addressing misconceptions regarding influenza vaccines during MTM consults. Patients often say, “I have gotten the flu shot before and sometimes still come down with the flu. What is the point of continuing to get the flu vaccine?” The influenza vaccine can still provide protection against serious complications even if individuals contract the virus. Evidence shows that influenza vaccines can reduce the risk of influenza-related hospitalizations.⁷ 

Patients may also say they have never had influenza, and do not see the value in vaccination. In fact, less than 20% of adults in the US are aware that influenza complications can include myocardial infarction, worsening of diabetes, stroke, and disability.⁸ Healthy individuals and those with chronic health conditions can develop serious complications, so emphasizing an annual influenza vaccine for all patients is critical. Many patients that pharmacists interact with during MTM consults are likely taking multiple medications for chronic health conditions and are therefore at an even greater risk of flu complications. Pharmacists can evaluate patients’ risk factors as part of influenza vaccine counseling pearls, such as informing patients 65 years and older that they have a higher risk of influenza-related complications.⁹

Health conditions that can put patients at risk for flu complications include, but are not limited to, asthma, chronic lung diseases (eg, chronic obstructive pulmonary disease), neurological conditions, diabetes, renal dysfunction, immunocompromised status, and cardiovascular disease.⁹

Conclusion

Pharmacists are uniquely positioned to bridge the gap between declining influenza vaccination rates and improved public health outcomes. Through proactive engagement during MTM consults, pharmacists can leverage motivational interviewing techniques, tailor vaccine recommendations to high-risk populations (eg, adults 65 years and older), and address persistent misconceptions that contribute to vaccine hesitancy. By identifying patient-specific risk factors, including chronic conditions such as diabetes, cardiovascular disease, and chronic lung diseases, pharmacists can personalize counseling in a way that resonates with each patient and underscores the real consequences of forgoing annual vaccination. The evidence is clear: When pharmacists take an active role in vaccine education, patients are more likely to accept immunization and protect themselves from potentially serious complications.

As the 2026 to 2027 influenza season approaches, the pharmacy setting remains one of the most accessible and trusted points of care for vaccine education and administration. Pharmacists, pharmacy interns, and pharmacy technicians all play a role in creating a culture of immunization within their communities. Recommending optimal timing, guiding appropriate vaccine selection, and engaging hesitant patients with empathy and evidence-based communication are all within the pharmacist's scope of practice. By integrating influenza vaccine discussions into every applicable MTM encounter, pharmacists can make a meaningful contribution to improving vaccination rates, reducing hospitalizations, and safeguarding the health of their patients, one conversation at a time.

About the Author

Jennifer Gershman, PharmD, CPh, PACS, is a drug information pharmacist and Pharmacy Times contributor who resides in South Florida.

REFERENCES

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8. Most US adults unaware of the dangers of flu for individuals with chronic health conditions. National Foundation for Infectious Diseases. December 3, 2018. Accessed June 12, 2026. https://www.nfid.org/most-us-adults-unaware-of-the-dangers-of-flu-for-individuals-with-chronic-health-conditions/

9. People at increased risk for flu complications. CDC. September 11, 2024. Accessed June 12, 2026. https://www.cdc.gov/flu/highrisk/index.htm