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Pharmacist-Led Interventions Significantly Increase Pneumococcal Vaccine Uptake in Older Adults

Key Takeaways

  • Pharmacist-led interventions significantly boost vaccination rates, especially for pneumococcal vaccines, among older adults.
  • Pharmacists acting as educators, facilitators, and advocates have the highest impact on vaccine uptake.
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Education initiatives, facilitation, and immunization on the part of pharmacists were found to significantly increase uptake of pneumococcal vaccines among older adults.

Pharmacist-led interventions on a series of vaccination uptake initiatives, including for pneumococcal vaccination, led to substantial increases in vaccination among older adults, with the greatest improvements occurring when pharmacists serve as educators, facilitators, advocates, and immunizers, according to a systematic review and meta-analysis published by investigators in Research in Social and Administrative Pharmacy.1

Vaccination in the shoulder

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Importance of Pharmacists in Preventing Disease With Vaccines

Vaccine-preventable diseases continue to cause major burdens for older adults, especially as the proportion of individuals aged over 60 rapidly increases. Multiple research initiatives have elucidated the impact of these diseases on older adults, with CDC reports detailing that most associated hospitalizations and deaths due to influenza occurred among adults aged 65 years and older. Furthermore, a survey in Australia found that pneumococcal pneumonia and influenza constituted the highest associated disabilities for older adults.1-3

Of course, vaccines are available to help reduce the burden of disease and promote healthy aging among older adults. Despite being a priority of governments, multinational organizations, physicians, and pharmacists, vaccination coverage among individuals aged 60 years and older remains suboptimal in a variety of vaccine-preventable diseases. For example, in European countries, pneumococcal vaccination uptake among older adults is reported at only 24.2%, which showcases the need for more effective methods to improve coverage.1,4

As reliable, trusted, and accessible health professionals, pharmacists are in a prime position to facilitate immunizations for pneumococcal and other vaccine-preventable diseases. Still, they may face extensive barriers to effectively proliferating vaccines to patients, including having limited knowledge of vaccination guidelines and a lack of resources in their pharmacies. It is critical to determine these barriers and assess the state of pharmacists’ capabilities as vaccinators to enhance their role.1,5

Many studies have sought to assess the role of pharmacist-led interventions in pneumococcal, influenza, and other vaccine-preventable diseases. These assessments have praised the role of pharmacists in providing vaccination services but have contained critical limitations, including excluding pharmacists that have multiple roles and including studies with weak trial designs. In this present systematic review, the investigators focus on the impact of pharmacist-led interventions on vaccination among older adults across all major vaccines, including pneumococcal, aiming to provide substantial evidence on the global impact of these interventions on vaccine uptake.1

In the review, the investigators addressed the following: determining the role of pharmacists in delivering pneumococcal and other immunization services for older adults and elucidating outcomes of pharmacist-led interventions on pneumococcal and other immunizations among older adults. Major outcomes of interest included the rate of vaccine uptake—which was defined as the number of older adults vaccinated following any type of intervention—and the roles of pharmacists, categorized as facilitators, immunizers, advocates, educators, or some combination of these roles.1

Pharmacist-Led Interventions Include Education and Facilitation

The included studies focused on varying vaccines administered to older adults. Four focused on pneumococcal vaccinations, 3 focused on influenza, 5 focused on herpes zoster (HZ) vaccination, and 1 assessed either pneumococcal or influenza vaccinations. None of the included studies investigated respiratory syncytial virus (RSV) or COVID-19 vaccinations.

A variety of interventions were employed by pharmacists. Three studies featured pharmacists conducting educational interventions to promote vaccine acceptance, addressing multiple topics, including the risk and transmission of pneumococcal disease and the need to avoid delays in vaccination. Furthermore, multiple studies featured the pharmacist in the immunization process as both an educator and a facilitator. They provided participants with information about the recommendations and criteria surrounding pneumococcal vaccines, in addition to the benefits and possible side effects of pneumococcal vaccines.1

In facilitating receipt of the vaccine, pharmacists assisted in identifying eligible patients, obtained their consent for vaccination, and contacted the appropriate health care provider to recommend the administration of the vaccine.1

The investigators sought to measure the effects of these pharmacist-led interventions on older adults and their vaccination uptake. All the studies were included in the meta-analysis. They found that, in the pre-post studies, pharmacist-led immunization services were associated with a significantly higher pooled relative risk (RR) of vaccine uptake (RR: 3.29 [95% CI, 2.01–5.39]). For the randomized trials, these interventions were again linked to a heightened increase of vaccine uptake (RR: 3.04 [95% CI, 1.46–6.34]).1

Highest Impact Found for Pneumococcal Vaccination Uptake

A subgroup analysis of pre-post studies included in the review found that pharmacists had the highest impact on vaccination uptake when they served as educators and facilitators (RR: 26.26 [95% CI, 4.23–163.11]) or as advocates (RR: 15.93 [95% CI, 6.44–39.14]). Critically, when pharmacists solely served as educators, their role was not meaningfully associated with increased uptake, signifying that pharmacists are at their best when actively serving as facilitators or immunizers for patients.1

Importantly, a statistically significant impact on pneumococcal (RR: 11.17 [95% CI, 1.92–64.95]) and HZ (RR: 4.01 [95% CI, 1.51–10.7]) vaccine uptake was observed, with no significant impact found for influenza vaccination.1

“Policymakers and health care organizations should prioritize pharmacist-led initiatives that leverage their diverse roles to improve vaccination coverage and promote healthy aging,” the investigators concluded.1

REFERENCES
1. Amare SN, Yee KC, Leung M, Naunton M, Bushell M. Impact of pharmacist-led interventions on COVID-19, herpes zoster, influenza, pneumococcal, and respiratory syncytial virus vaccines uptake in people aged 60 years and older: Systematic review and meta-analysis. Research Social Admin Pharm. Available Online 2025. doi:10.1016/j.sapharm.2025.06.110
2. CDC. Flu and people 65 years and older. Updated September 5, 2024. Accessed July 17, 2025. https://www.cdc.gov/flu/highrisk/65over.htm
3. Australian Institute of Health and Welfare. The burden of vaccine preventable diseases in Australia. Released November 1, 2019. Accessed July 17, 2025. https://www.aihw.gov.au/reports/immunisation/the-burden-of-vaccine-preventable-diseases/summary
4. International Longevity Centre UK. European pneumococcal vaccination: A progress report. Released January 24, 2023. Accessed July 17, 2025. https://ilcuk.org.uk/european-pneumococcal-vaccination-a-progress-report/
5. Halpern L. Pharmacists face key knowledge barriers to ensuring effective pneumococcal vaccination. Pharmacy Times. Published April 10, 2025. Accessed July 17, 2025.

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