Barriers Shown to Decrease Uptake of Vaccines Administered in Community Pharmacy

Many Americans, especially older adults, suffer each year due to vaccine-preventable diseases, such as influenza, pneumococcal disease, and shingles. Currently, low immunization rates prompt a combined effort to vaccinate more people.

Pharmacists, due to their accessible locations, can help the immunization effort by supporting and giving vaccines. More than 90% of American live within 2 miles of community pharmacies. The CDC found that in 2017, pharmacies alone administered 28.2% of total flu shots in the United States.

While pharmacists contribute significantly to flu vaccination, non-flu vaccination rates in community pharmacies are unknown.

A study published in April 2020 in Vaccine determined percentages of different vaccinations administered in Wisconsin pharmacies and current barriers to immunization.

Using the Wisconsin Immunization Registry, the study showed that pharmacists in the state of Wisconsin are most likely to give zoster and influenza vaccines (39% and 20%, respectively). The study points out the high coverage rate for Medicare Part D beneficiaries enables high zoster vaccination rates. Medicare Part B, however, only covers influenza, pneumococcal, and hepatitis B vaccines.

Human papillomavirus vaccines (HPV) had the lowest administration rate (0.2%) in the state. The study explains the low HPV vaccination rate is due to a lack of public awareness of its importance.

Moreover, of the 86% of Wisconsin pharmacies that provide immunizations to customers, 84% stock flu vaccines, whereas much fewer (21%) stock HPV vaccines.

In the study, pharmacists who gave vaccines say competing tasks are the most significant barrier to increasing their vaccination metrics.

In terms of pharmacies, the study shows that cost of unused vaccine stock, supplies, maintaining adequate inventory, and the expiring vaccines are also barriers to better vaccination rates.

While only trained pharmacists and pharmacist interns can administer vaccines in Wisconsin’s community pharmacies, evolving policies could enable pharmacy technicians to vaccinate. The study predicts that since the community pharmacy is becoming the setting for routine immunization, the vaccination process may benefit from involving additional staff.

To improve immunization rates from a patient’s perspective, letting them know through direct conversation and personalized letters is more effective than flyers and automatic voice messages. The study also mentions patients more likely to receive vaccines from pharmacists if their providers recommend it. The pharmacists interviewed in the study overwhelmingly (98%) shared a willingness to collaborate with providers in other settings for immunization.

In general, the study found that community pharmacy has a considerable role in immunization. The pharmacies in Wisconsin show that fewer competing tasks, better patient education, reduced vaccine-related cost, and increased provider collaboration will enhance pharmacists’ ability to administer more vaccines.

Xiaoyu (James) Lu is a 2021 PharmD candidate at the University of Connecticut in Storrs.

REFERENCE

Berce PC, Bernstein RS, MacKinnon GE, et al. Immunizations at Wisconsin Pharmacies: Results of a statewide vaccine registry analysis and pharmacist survey. Vaccine. 2020;38(28):4448-4456. doi: 10.1016/j.vaccine.2020.04.043