Fight the Flu: Get Vaccinated

The Centers for Disease Controland Prevention (CDC) estimatesthat every year in the UnitedStates, on average, 5% to 20% of thepopulation is infected with the influenzavirus; >200,000 individuals arehospitalized from flu complications;and 36,000 patients die from the flu.The CDC has designated the weekof December 8 to 14 as NationalInfluenza Vaccination Week to highlightthe importance of continuing theflu vaccine.

For the 2008-2009 flu season, vaccinemanufacturers project that between 143million to 146 million doses of the influenzavaccine will be available. The FDArecently approved 6 flu vaccines forthis influenza season. The flu vaccine isrecommended for individuals aged 50and over, pregnant women, individualswith chronic medical conditions, nursinghome or long-term care residents,and individuals who live or care forthose at high risk for complicationsfrom the flu. The 2008-2009 flu season marks the firsttime all healthy children aged6 months up to their 19th birthdayare recommended to getthe vaccine.

The CDC also recommendsthat adults aged 60 and olderbe vaccinated with Zostavax(Zoster Vaccine Live [Oka/Merck & Company Inc]) to preventherpes zoster, commonlyknown as shingles. Zostavaxis the only vaccine to preventherpes zoster.

As the most accessiblehealth care providers, pharmacistsare in a unique positionto advocate the importanceof vaccinations. In addition,many independent and chainpharmacies offer vaccinationservices and annual flu programs.

The National Community PharmacistsAssociation's (NCPA) 2007 NCPA-PfizerDigest found that 43% of independentcommunity pharmacists offer immunizations.The association expects thatnumber to hold steady as it collects datafor the 2008 publication.

Katterman's Sand Point Pharmacy

Katterman's Sand Point Pharmacy inSeattle, Waghington, is an "immunizationdestination," according to co-ownerBeverly Schaefer, RPh. The pharmacyprovides all vaccines available, includingseasonal flu, FluMist, and pneumoniaimmunizations.

Shaefer explained that the pharmacyhas a year-round immunization businessthat includes routine immunizations,such as hepatitis A, hepatitis B, polio,human papillomavirus (HPV), meningococcal,chickenpox, and shingles. Inaddition, it offers travel immunizationslike typhoid, yellow fever, and Japaneseencephalitis.

"All immunizations are administeredby a pharmacist and all are available ona walk-in basis without an appointmentand without a doctor's prescription.Washington State allows us to have acollaborative practice agreement with alocal physician that gives us prescriptiveauthority for all vaccines," she said.

When the pharmacy administers thevaccine, with the exception of the flu,it sends a fax to the patient's primarycare physician, so immunizations canbe recorded in the patient's medicalrecord. It also serves as a reminderfor physicians on where they can referpatients for immunizations not routinelyoffered in doctor's offices.

Katterman's does about 3000 flu shotsannually and offers the service fromOctober through May. No appointmentis necessary, walk-ins are welcome, noprescription is required, and shots areavailable when the pharmacyis open. When the pharmacybegan offering the flu vaccinein 1996, it was one of the firstpharmacies to offer large-scaleimmunizations. "We did 1200flu shots our first year. Wewere successful and profitablebeyond our wildest expectations,"said Shaefer.

The pharmacy also offersthe Zostavaxvaccine. The vaccinehas been offered since itreceived FDA approval in May2006, and the pharmacy hasdone >500 immunizations. Thepharmacy can administer boththe flu and Zostavax vaccinesat the same time if they areavailable.

"In addition to increasingaccess to medical services,offering immunizations is profitable for pharmacies. Immunizationsare now more than 10% of our pharmacybusiness," she said. "It takes about thesame amount of time as filling a newprescription. It increases foot trafficin the pharmacy. Many people seekingimmunizations buy other products orprescriptions (often in the case of travelimmunizations). It allows the pharmacistto be a source of health informationfor both patients and physicians year-round."

SUPERVALU

In 2000, the SUPERVALU Adult Immunizationprogram was established to helpprovide the communities the storeserves with convenient access to preventivehealth care. Specially trainedand certified SUPERVALU pharmacistscan administer the Zostavax vaccine byappointment in many of the pharmaciesyear-round, reported Jeff Bregar, RPh,manager of the Adult ImmunizationProgram. To date, the pharmacies have"administered >15,000 doses and educatedthousands of patients about theZostavax immunization, as well as availableinsurance options to help themmake wise and healthy choices," he said.The vaccine is covered by Medicare PartD, Medicare Advantage, and other insuranceproviders. The pharmacy also providesa range of adult vaccines.

SUPERVALU has been offering fluclinics for >10 years. Immunizing pharmacistswill provide traditional flu shotsand the no-needle FluMist nasal sprayvaccine by appointment or on a walkinbasis at in-store pharmacies throughFebruary. Both vaccines also will beoffered at special, in-store flu vaccineclinics through December. In addition toproviding flu vaccines at each of its 920in-store pharmacies, it will offer nearly3000 flu clinics nationwide, said Bregar.

The cost for the flu shot is $24.99, andMedicare Part B, Medicare Advantage,and other insurance plans are accepted.To minimize wait times, individuals areencouraged to make an appointment.Appointments are not required for thewalk-in flu clinics, where patients areseen on a first-come, first-served basis.For more information, patients cancall 800-783-0458 (Jewel Osco patientscan call 866-388-1805) to schedule anappointment and find a nearby location;visit the in-store pharmacy to makean appointment or ask questions; orvisit healthprograms.supervalu.com and click on the "Health ProgramsLocator."

Publix

Publix offers the Zostavax vaccine in itsAlabama, Tennessee, South Carolina,and Georgia locations with a prescription.Patients should contact their Publixpharmacist for the schedule. Publix alsooffers the pneumococcal, tetanus anddiphtheria (TD), and tetanus, diphtheria,and pertussis (TDaP) vaccines.

For >6 years, Publix has been offeringthe flu shot program, which runs throughDecember 15. The cost for the flu shot is$30, and Medicare Part B is accepted forthe influenza and pneumococcal shots.The other immunizations are cash only.Many locations will offer walk-ins orappointments. Patients can find moreinformation by visiting www.publix.com/flu, by calling 877-629-3580, or by speakingwith a Publix pharmacist.

Rite Aid

Rite has been offering the Zostavax vaccinefor 4 years. The vaccine is administeredby pharmacists in states wherepermitted and according to state regulations.Cost varies depending on insurance.Normally appointments are notneeded, but since this vaccine in is highdemand and orders take a few weeks,appointments are recommended. Othervaccination services include pneumococcal,meningococcal, hepatitis A, hepatitisB, HPV, and TDaP.

The pharmacy chain will host a 3-dayflu and pneumonia shot clinic this month.Patients also can receive flu shots fromany of its 1200 immunizing pharmaciststhrough the season by appointment. Inaddition, the flu shot will be available atRite Aid stores that host in-store clinicsfrom its clinic partners. Nearly 2600 flushot clinic events will be held this fall at1300 stores.

The cost for the flu shot is $30, free forpatients with Medicare Part B, and someprivate insurance plans are accepted.The vaccine will be administered on afirst-come, first-served basis at the fluclinics. At locations with an immunizingpharmacist, patients will need tomake an appointment. Patients can findout more information by visiting www.riteaid.com, speaking with a pharmacist,or calling 866-751-1494.

CVS/pharmacy

CVS does not administer the Zostavaxvaccine. If a patient has a prescriptionfor the vaccine, the pharmacy will transferthe prescription to its specialty mail-orderunit, which will coordinate scheduleswith the patient and the physicianand ship the drug directly to the physicianfor administration of the vaccineto the patient. Additional vaccinationservices administered by nurse practitionersat CVS MinuteClinics includeTD, pneumococcal, and polio.

CVS, which has been offering flu clinicsfor >10 years, will have store clinicsoperating until the end of this month.Flu shots at MinuteClinics will be availablethe entire flu season. A total of 7500flu clinics will be held in CVS/pharmacylocations. Scheduled clinics will operateon a first-come, first-served basis. Inaddition, flu shots will be available ona walk-in basis, no appointment necessary,at CVS/pharmacy's 540 in-storeMinuteClinic locations.

Each flu shot is $30. Medicare PartB recipients who have not reassignedtheir prescription coverage benefits toan HMO may get the flu shot at nocost when they present their MedicarePart B card. Patients can find out moreinformation by calling 888-FLU-SHOTor visiting www.cvs.com and clickingon the store finder link. All stores hostingclinics also will have flu clinic schedulesposted.

Walgreens

Walgreens has been offering flu shotclinics for >12 years. For the first time,most Walgreens locations also will offerthe FluMist nasal spray as an alternativeto the shot. In addition to Walgreenspharmacies, patients can receive theflu vaccine at all 237 Take Care Clinics.Board-certified nurse practitioners andphysician assistants will administer theshots and nasal spray.

The cost for the flu shot is $24.99at most Walgreens locations, andthe nasal spray is $29.99. MedicarePart B is accepted, and the vaccinationsmay be covered by insuranceplans. Patients are encouraged tocheck with their insuranceprovider.Appointments are recommended atWalgreens pharmacies. Take CareClinicswill offer the vaccine 7 days aweek with no appointmentrequired.Patients can find additional informationby calling 800-FLU-9950 or visitingwww.walgreens.com/flu and www.TakeCareHealth.com.

Kmart

Kmart Pharmacy will operate flu clinicsthrough November 13. The vaccine willbe offered at >900 pharmacist-based and400 nurse-based clinics and nonpharmacylocations throughout the country.Flu shots at the pharmacy are $25 andpneumonia shots are $50. Patients canfind out more information by visitingwww.kmart.com, calling 800-822-8345,or asking a Kmart pharmacist.

Wal-Mart

Whereas Wal-Mart pharmacists willnot administer the flu immunization,nurses will be available to administerthe vaccine in some pharmacies andSam's Clubs. The flu shot program runsthrough November 8.

The cost for the flu shot is $29 and willbe conducted on a first-come, first-servedbasis. Patients can find more informationfrom in-store signage or by visiting www.flushotusa.com/walmart.