Keeping a Killer at Bay: Pharmacists Can Combat Pneumococcal Infection

Streptococcus pneumonia is an indiscriminate killer.

Streptococcus pneumonia is an indiscriminate killer. When it causes bacteremia or meningitis, collectively referred to as invasive pneumococcal disease, 30% of affected individuals die. Public health officials continue to be concerned because many adults don't take advantage of the best preventive measure: vaccination.

Researchers from Birmingham, AL, address pneumococcal vaccine uptake among working-age adults with chronic morbid conditions in a study published in the January 2017 issue of Infectious Diseases in Clinical Practice. Their purpose was to elucidate community pharmacists' practices and perspectives on immunizations.

These researchers interviewed pharmacists who worked at 12 independent community pharmacies in the state of Alabama. After analyzing data, they looked for information about community pharmacists' knowledge, practices, and perspectives on pneumococcal vaccination for at-risk working-age adults.

Very few pharmacists had immunized at-risk adults aged 19 to 64 with pneumococcal vaccinations. They reported pneumococcal vaccination volumes of 5 to 150/year, with most given to patients older than 65 years.

Pharmacists self-reported good knowledge about pneumococcal vaccination, but had knowledge gaps regarding recent Advisory Committee on Immunication Practices (ACIP) recommendations for vaccine use in at-risk adults. They tended to know which patients are considered at-risk (the elderly, smokers, and patients with asthma or diabetes). They were less able to identify ACIP's risk-based recommendations.

The authors note that the ACIP’s frequent revisions to the pneumococcal vaccine recommendations likely contribute to pharmacist confusion.

Pharmacists identified immunization record maintenance as an area needing improvement, and few had proactive strategies to engage working adults. Most often, pharmacists linked the pneumococcal vaccine to the influenza vaccine, although there was no need to do so.

Pharmacy-specific barriers varied among the pharmacies, and included advocacy, public misperceptions, limited collaboration with area physicians, and resource constraints.

Pharmacists said they believe that growing acceptance of pharmacy-based immunization will help reach more working age adults. They acknowledged that the business case for pneumococcal vaccination is strong, but creating the case will take resources they may not have.

Reference

Kulczycki A, Wensel TM, Hogue M. Practices, challenges, and opportunities to improving pneumococcal immunization in working-age, at-risk adults through community pharmacies. Infect Dis Clin Pract. 2017;25: 23—28.