Idaho Leading the Way in Advancing Technician Roles in Immunizations

Vaccine-preventable diseases are a serious public health concern because they may cause long-term illness, hospitalizations or death.¹ Vaccine-preventable diseases account for the deaths of approximately 42,000 adults and 300 children in the United States annually.² The United States has an estimated 45.6% flu vaccination coverage which is well below the Healthy People 2020 target of 80%.³

One method of addressing low vaccination rates is through immunizations provided in the pharmacy. Pharmacists are trusted health care providers serving individuals in many communities and settings around the United States.^4,5 Pharmacists are one of the most accessible healthcare providers, as the average American lives within 5 miles of the nearest community pharmacy.⁶

In 1995, 9 states in the United States passed legislation that would allow pharmacists to administer vaccinations: Alabama, California, Colorado, Georgia, Illinois, Michigan, Montana, South Carolina and Washington.⁷ Currently, pharmacists in all 50 states, as well as the District of Columbia and Puerto Rico, are allowed to administer immunizations. Maine became the last state to allow pharmacist to administer immunizations in 2009.⁸ Pharmacies across the United States are now recognized as an accessible resource for improved public health through immunizations. The CDC reports the second most common place for adults to receive flu vaccinations is at a pharmacy/store (24.3%), second only to doctor’s offices (37.4%).⁹

As the role of the pharmacist continues to evolve into expanding clinical services, pharmacy technicians have been called upon to help fill in the gaps. Technicians are an integral part of the day to day workflow and provide vital support to the pharmacist. Often the pharmacy technician is the 'face' of the pharmacy, frequently interacting with patients and customers.

As of April, 2017, the Idaho Board of Pharmacy made a change to their legislation regarding the administration of immunizations.¹⁰ Pharmacists in Idaho may now delegate the technical task of administering an immunization to a certified technician. This change does not allow the pharmacy technician to perform the clinical judgement on the appropriateness of the immunization, but instead allows for the task of physically administering the immunization to be delegated. Patient screening, counseling, and prescription verification still is the sole responsibility of the pharmacist.

This legislation requires the technician to hold a current certification in basic life support and complete an ACPE-accredited course on appropriate immunization administration technique. This does not change any other parts of the immunization process. Currently, in Idaho, there are no limitations on types of vaccine, routes, ages or administration sites for pharmacists and this has been extended to include the technician as well. The pharmacist will still need to evaluate the patient for appropriateness, safety, and provide counseling prior to immunization administration.

As the role of the pharmacist continues to grow, utilizing pharmacy technicians to administer immunizations may improve workflow and allow pharmacists more time to focus on providing other clinical services. Having yet another member of the healthcare team who can administer immunizations may also improve immunization rates and reduce the public health impact of vaccine-preventable diseases.

This article was co-written by Kyle Frazier, PharmD.

References

• Vaccine-Preventable Adult Diseases. Centers of Disease Control and Prevention. https://www.cdc.gov/vaccines/adults/vpd.html. Updated December 16, 2016. Accessed April 3, 2017.
• Immunization and Infectious Disease. Healthy People 2020. https://www.healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases. Accessed April 5, 2017.
• FluVaxView. Centers of Disease Control and Prevention. https://www.cdc.gov/flu/fluvaxview/reportshtml/reporti1516/reporti/index.html. Updated September 29, 2016. Accessed April 3, 2017.
• Knapp KK, Paavola FG, Maine LL, Sorofman B, Politzer RM. Availability of primary care providers and pharmacists in the United States. J Am Pharm Assoc. 1999;39(2):127-35.
• Honesty/Ethics in Professions. Gallup Web site. http://www.gallup.com/poll/1654/honesty-ethics-professions.aspx. Accessed January 9, 2017.
• DeArment. A. Pharmacists are face of health care in community. RxImpact. 2012 Mar; 4-5. Accessed 27 July 2016.
• Steyer, T. E., Ragucci, K. R., Pearson, W. S., & Mainous, A. G. (2004). The Role of Pharmacists in the Delivery of Influenza Vaccinations. Vaccine, 1001-1006.
• Yvette, T. C. Vaccinations: The Expanding Role of Pharmacists. Pharmacy Times. http://www.pharmacytimes.com/publications/issue/2010/january2010/featurefocusvaccinations-0110. Published January 14, 2010. Accessed April 5, 2017.
• National Early-Season Flu Vaccination Coverage, United States, November 2016. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/fluvaxview/nifs-estimates-nov2016.htm. Published December 9, 2016. Accessed April 3^rd, 2017.
• Public Hearing: Rules of the Idaho State Board of Pharmacy Docket Number 27-0101-1603. October 31,2016 Rule 330.03, 264.