Pharmacists Engaging Adults to Be Vaccinated

Vaccines are one of the most effective and successful public health tools to prevent disease, illness, and premature death. Educating patients and administering influenza vaccines has become a core component of a pharmacist’s practice. The CDC estimates that in 2015, 1 in 4 adults received an influenza vaccine in a community pharmacy.¹ If you are one of the more than 280,000 immunization-trained pharmacists in the United States, you are winding down from another busy flu season. Have you considered what happens when the flu season is over? Protecting adults from vaccine-preventable diseases does not end when the last flu shot is given.

MISSED OPPORTUNITIES

The Advisory Committee on Immunization Practices (ACIP) recommends 13 vaccines for adults 18 and older.² However, despite increased numbers of immunization providers, including pharmacists, and greater access through convenient health care destinations, reports continue to show that adult vaccination rates are extremely low.³ Most adults don’t realize they need vaccines throughout their lifetime. Table 1^3,4 provides a summary of the estimated 2014 vaccination rates of 5 adult vaccines compared with the Healthy People 2020 targets from the US Office of Disease Prevention and Health Promotion.^3,4 Vaccination rates are failing to meet health care quality measures. To put this concern in perspective, childhood vaccination rates in the United States typically exceed 90%.⁴ Additional work is needed from immunization providers to improve vaccine coverage for adults.

ENGAGING ADULTS IN VACCINE NEEDS

Adult vaccine advocacy groups have identified factors contributing to low adult vaccination rates and the motivators that will bring those rates up.⁵ One of the key findings is that patients are receptive to being vaccinated when the immunization provider engages in conversations about the patient’s immunization status and provides clear recommendations for the vaccines that are needed. As immunization providers, pharmacists are incredibly knowledgeable about vaccines and vaccine-preventable diseases. They should not underestimate the influence their education and recommendations have on impacting the health and well-being of patients.

Most patients will visit their local pharmacy more often than their primary care provider’s office. The pharmacist is in a key position to assess and communicate about a patient’s specific vaccine needs. Pharmacists will need to use a team approach to improve the likelihood of adult vaccine awareness. Pharmacy technicians should be trained to regularly ask patients for updates on their immunization histories at the prescription drop-off window. The technician can then refer patients to consult with the pharmacist about their specific vaccination needs. Further, student pharmacists and interns can assist with reviewing patient profiles during dispensing activities to identify patients who may be eligible for vaccination( s) and assist with providing recommendations to those patients. Pharmacists should routinely assess patients’ vaccination needs to ensure they are up-to-date with ACIP recommendations and utilize patient care opportunities, such as medication therapy or disease management consultations, to recommend necessary vaccinations.

ARE YOU FULLY IMMUNIZED?

The CDC’s vaccine coverage data for influenza and hepatitis B in health care personnel (Table 1^3,4) indicates that health care personnel are also contributing to low adult vaccination rates.^3,4 As trusted immunization providers, pharmacists need to be up-to-date on their own vaccines. It is important that you serve as a role model to your patients by practicing what you recommend. Patients may be more willing to accept your vaccine recommendations if you share that you received the same vaccination.

SHARE THE MESSAGE

Table 2⁶ provides the SHARE consultation guide that can help pharmacists when crafting their message to patients about vaccination needs.⁶ It is important for pharmacists and their pharmacy team to remember that persistence is key in educating about adult vaccines. In many cases, it will take repetition of vaccination recommendations before the patient will get vaccinated.

The most important goal of any vaccine program is to instill, build, and maintain high confidence in vaccines. This is something that does not end with the influenza season; it should be part of a pharmacist’s everyday practice. Pharmacists who routinely engage adults in conversations about recommended vaccinations will be contributing to improving patient knowledge, immunization rates, and public health. ®

Judy Sommers Hanson, PharmD, FAPHA, is manager, clinical program development and residency programs, Walgreen Co, Deerfield, Illinois.

References

• American Pharmacists Association. CDC recognizes pharmacists’ contributions to improving immunization access. APhA website. pharmacist.com/cdc-recognizes-pharmacists-contributions-improving-immunization-access. Published October 6, 2015. Accessed February 3, 2017.
• CDC. Recommended immunization schedule for adults aged 19 years or older, 2017. CDC website. cdc.gov/vaccines/schedules/downloads/adult/adult-combined- schedule.pdf. Accessed February 7, 2017.
• Williams W, Lu P, O’Halloran A, et al; CDC. Surveillance of vaccination coverage among adult populations-United States, 2014. MMWR Surveill Summ. 2016;65(1):1-36. doi: 10.15585/mmwr.ss6501a1.
• Office of Disease Prevention and Health Promotion. Healthy people 2020: immunization and infectious diseases. Healthy People website. healthypeople. gov/2020/topics-objectives/topic/immunization-and-infectious-diseases/objectives. Accessed February 7, 2017.
• US Department of Health and Human Services National Vaccine Program Office. National Adult Immunization Plan. HHS website. hhs.gov/sites/default/files/nvpo/ national-adult-immunization-plan/naip.pdf. Accessed February 3, 2017.
• National Vaccine Advisory Committee. Recommendations from the National Vaccine Advisory Committee: standards for adult immunization practice. Sage Journals website. http://journals.sagepub.com/doi/ pdf/10.1177/003335491412900203. Accessed February 7, 2017.