Increasing Vaccination Rates to Decrease Death Rates

Pharmacists were inducted into the world of immunizations about 20 years ago when they were first authorized to administer vaccines, making immunizations more accessible. Despite our nation’s progress with vaccinations, approximately 42,000 adults and 300 children die each year due to vaccine-preventable diseases.¹

Pharmacists are in an optimal position to ensure that patients are up-to-date on recommended immunizations. However, many factors may make engaging patients over the pharmacy counter more difficult than expected. Patients may be distracted, hesitant, or in too much of a rush when the pharmacist is trying to recommend a vaccine. Misperceptions about the risk of disease as well as about the vaccines themselves—including their effectiveness, perceived adverse effects, and usefulness as preventative health measures—are also significant barriers that pharmacists must overcome in the time they have with the patient. A study conducted by the National Consumers League in 2013 found that 1 in 5 adults did not receive a seasonal flu vaccine that year because they did not believe the disease for which it afforded protection was a serious condition. Also, 1 in 5 adults indicated they were simply afraid of getting the flu from the vaccine. ² To overcome these challenges, pharmacists should use a team-based, holistic approach.

The first step in ensuring that patients leave the pharmacy with all recommended immunizations is making sure that the entire pharmacy team is involved. Technicians, clerks, interns, students, and pharmacists should all work together to ensure that their patients are taken care of from the minute they approach the pharmacy counter. When patients drop off prescriptions, this is the team’s first opportunity to assess the patient’s immunization needs. Technicians can use a “cheat sheet” of the flags that indicate a patient’s vaccine needs. For example, patients 60 years or older should be assessed for the shingles vaccine; those 65 or older should be assessed for pneumococcal vaccines; and all adults should be assessed for the tetanus booster.³ Introducing the idea of vaccines at the prescription drop-off gives hesitant patients time to think about the recommendation. The pharmacist can then provide reinforcement during prescription pick-up, addressing any concerns or questions the patient may have. When patients drop off prescriptions, technicians should also be updating the profile with medical conditions to help provide a broader picture of potentially necessary vaccinations.

Another important factor when discussing vaccines with patients is to be sure recommendations are provided confidently and professionally. Have a strong foundation of knowledge about the vaccines you are recommending, including examples and personal stories on hand to help support your recommendations. Patients learn about the importance of vaccines from a variety of sources, but hearing anecdotes based on others’ experiences can help sway a patient who is hesitant.

Finally, for the patient who is adamant about refusing vaccines, it is helpful to learn why, exactly, the patient is declining. Patients appreciate being listened to, and only if you hear their specific concerns will you have the opportunity to address them intelligently. Realize that not every patient will be convinced right away. Some patients require time to let the information you provide sink in, and for such patients, having a standard follow-up procedure in place is crucial.

Vaccination rates have increased in recent years, and immunizations in the pharmacy are rapidly expanding with the implementation of travel health programs and technician immunization protocols. Still, there is always room for improvement. Patients see their pharmacists more frequently than they see most other health care professionals, and pharmacists remain among the most trusted in the health care field. We have an opportunity to be leaders in a vital national public health effort, and we can positively affect the health of our communities.

Melissa Belli, PharmD, BCACP, is residency program coordinator for ACME Savon Pharmacy, a division of Albertsons Companies. She is also an adjunct faculty member atPhiladelphia College of Pharmacy and Temple University.

References

1. US Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Immunization and infectious diseases. Healthy People website. https://www.healthypeople.gov/2020/topics-objectives/topic/immunization-and-infectious-diseases. Updated March 15, 2017. Accessed April 12, 2017.

2. National Consumers League. US parents’ flu vaccine misconceptions concerning advocates. National Consumer League website. https://www.slideshare.net/nationalconsumersleague/national-consumers-league-2013-vaccine?from_action=save. Published November 21, 2013. Accessed March 8, 2017.

3. Recommended immunization schedule for adults aged 19 years or older, United States, 2017. CDC website. cdc.gov/vaccines/schedules/downloads/adult/adult-combined-schedule.pdf. Accessed April 12, 2017.