Count on Community Pharmacists to Increase Flu Immunizations

Community pharmacist vaccination programs have spread across Canada in recent years. Like their US counterparts, Canadian pharmacies are open long hours, ubiquitous, and provide services on a walk-in basis.

US states that allowed pharmacist vaccination the earliest had 7% (absolute) greater vaccination coverage than the national average. Of note, younger and rural patient vaccination increased the most.

Canada has funded its immunization campaign generously, but influenza vaccination coverage remains suboptimal. Therefore, different approaches are needed.

Canadian community pharmacists have expressed desire to expand their practice, and study results have indicated that 80% of Canadians prefer receiving vaccinations at pharmacy clinics. Another UK study found that 51% of patients were more willing to pay for a convenient vaccine at a pharmacy than to schedule a free appointment with their primary care provider (PCP).

An article published ahead-of-print in the Canadian Medical Association Journal shows that pharmacist vaccination programs have increased influenza vaccination coverage in Canada. The researchers used self-reported vaccination data from the Canadian Community Health Survey of 65,000 nonremotely-located, community-based civilians. They also noted patient demographic information, medical history, smoking status, and use of a PCP.

Between 2007 and 2014, Canada’s overall influenza vaccination rate was 28.8%. Patients in jurisdictions allowing pharmacist vaccination were immunized 30.4% of the time, compared with 28.2% in other jurisdictions.

Vaccination rates decreased over time across Canada (although the authors didn’t speculate why) and pharmacist vaccination had a modest tempering effect on this trend. Universal public payment, age older than 50 years, female sex, urban residence, history of chronic conditions, and having a PCP were associated with increased vaccination rates. Meanwhile, nonnative-born, healthy, and smoking respondents received influenza vaccinations less often.

The researchers were unable to determine how many pharmacist-vaccinated patients would have received a vaccine from a PCP otherwise. Notably, pharmacists in Canada are unable to provide vaccines to children, and 3 Canadian provinces don’t pay for pharmacist vaccination.

Overall, pharmacist vaccination programs increased influenza immunization modestly. Further research should target nonaccess-related barriers to care.