Pharmacists Bridging Immunization Follow-Up Gap

For many patients, the local pharmacist is the most accessible health care professional. When it comes to vaccinations, fostering this relationship can ensure continuity of care.

Pharmacists can now administer most vaccines in community pharmacies in most states, including those requiring a multidose series, such as the human papillomavirus vaccine.

The July­­−August 2016 issue of The Journal of the American Pharmacists Association highlighted pharmacists’ approaches and the developing needs associated with serial vaccines.

The CDC formulates recommendations for all immunizations that indicate target populations and dosing schedules to complete specific series. Vaccines that only need to be administered once a year or once in a lifetime (eg, zoster) are easy for a pharmacist to administer and require little to no tracking.

However, multidose vaccines administered in a series need follow-up to ensure subsequent doses are administered on time. The pharmacy must implement an appropriate reminder system to achieve continuity of care and integrate patients who return for scheduled immunizations into current workflow.

Several options for reminder systems have been explored:

· Immunization information systems (ISS), or registries, can support client reminder systems.

· Manual outreach, community education, incentives, community education, and case management may be part of a pharmacy’s current infrastructure, so staff could use it all for vaccination reminders.

· Text messaging, which is a good reminder option for teens and young adults, especially.

· Appointment-based synchronization with medications can also be employed.

The National Vaccine Advisory Committee recommends entering documentation into ISS and providing patients with a copy of their immunization records. This gives patients tangible reminder cards, which may make follow-up more likely.

The Immunization Neighborhood theory developed by the American Pharmacists Association addresses collaboration, coordination, and communication among immunization stakeholders, such as pharmacists and physicians. An example of collaboration is prescribers providing a prescription for follow-up immunization, in which the patient would go to the pharmacy when the next dose is due. This increases the chance of receiving a full series without having to visit the physician’s office or pharmacy more than necessary.

Many pharmacies may already have systems in place, but the key is to make sure they’re used.

Pharmacies should modify their current procedures to address expanding increased immunization needs. Pharmacists should use the reminder systems already in their infrastructures, follow public health agency guides, and collaborate with other providers to ensure that patients are fully immunized.