Immunization Administration and the Future of Pharmacy

CDC officials report that more than 25% of influenza vaccines are administered by pharmacists. It would be safe to say that the immunization role of pharmacists has become an important public health success. The American Pharmacists Association (APhA) has more than 300,000 pharmacists trained as immunizers.

I would suggest that pharmacy-based immunization efforts have played an important role in making community pharmacies into community health centers. I think these efforts have helped strengthen the image already held by patients that pharmacists are health professionals and probably contribute to the high ranking of pharmacists as trustworthy. Success as immunizers will make it easier for pharmacists to eventually be recognized by Congress as health providers under Medicare.

Beyond the community, pharmacists themselves have also benefitted, growing professionally because they have begun to immunize patients. The hands-on interaction of an injection gives many pharmacists the feeling of being a "real health team member." It hasn't always been that way, however. I remember when some community pharmacists saw the interruption of their prescription-filling role to give an injection as inappropriate or even unsafe. I no longer hear that discussion.

The bigger question, however, is how important will the role of immunizer be in pharmacy's future? Is administering injections a technical or professional function? I think it is a technical function. The judgment is should this specific patient receive an injection? I believe you can develop a set of rules that a trained pharmacy technician can perform. If the patient passes, then the injection can be given. If the patient doesn't pass, then a pharmacist can be consulted for a decision to be made. I know this position seems outlandish, as we have fought so hard in many state legislatures to get permission for pharmacists to administer injections and there are many states where we need to get the role expanded. Many states still limit the role pharmacy technicians can play, so expanding the role seems wrong to some and impossible to others.

As I look 20 years into the future, however, I don't see pharmacists giving immunizations because pharmacists will be practicing at the top of their license, managing chronic diseases, and treating many self-limited problems that cause patients to seek urgent care. We will look back then to today and see how important the role of becoming immunizers has been in advancing the profession.