Pharmacists Face Key Knowledge Barriers to Ensuring Effective Pneumococcal Vaccination

Despite expressing confidence in the ability of their pharmacies to provide pneumococcal vaccinations and coordinate tasks for implementing new vaccination services, many pharmacists demonstrated limited knowledge of pneumococcal vaccination guidelines, with barriers to vaccination including financial issues, a lack of resources, and patient-related factors.¹

Pharmacists face barriers to effective pneumococcal vaccination, especially among high-risk patients for whom pneumococcal disease can be deadly. | Image Credit: © Dr_Microbe - stock.adobe.com

These results, found in a cross-sectional study published in Vaccine that surveyed 124 community pharmacists in South Carolina, demonstrated how targeted education and interventions could aid in addressing these key barriers and, ultimately, enhance the effectiveness of immunization services in community pharmacies. Optimizing the vaccination process in community pharmacies is critical given the vulnerabilities of high-risk populations, such as older adults with chronic medical conditions, to pneumococcal infection.^1,2

Furthermore, pneumococcal vaccination uptake remains low, despite the proven effectiveness of the multiple approved pneumococcal-conjugate vaccines. Recent data from 2021 indicates that, in that calendar year, only 65.8% of US adults 65 years or older had received at least 1 pneumococcal vaccination. Even more troubling is the low 22.2% vaccination rate among adults falling in the high-risk category. Investigators in this trial sought to explore potential barriers to pneumococcal vaccination in community pharmacies while elucidating pharmacist knowledge regarding pneumococcal vaccines.^1-3

A total of 58 respondents from the original population completed the survey, which contained 33 questions across domains including barriers to administration, knowledge, current pharmacy immunization practices, and demographics. Interestingly, both PharmD-educated pharmacists (77.5%) and BSPharm-educated pharmacists (19.0%) fell into the sample, with respondents holding a variety of roles within their setting.¹

Regarding knowledge of pneumococcal vaccination, pharmacists were only able to identify the correct vaccination recommendation for an example patient 4 times with an overwhelming correct response. Each time, the example patient used to evaluate pharmacist knowledge fell into a high-risk patient category, the investigators noted. Barriers to pneumococcal vaccination perceived among pharmacists were also evaluated. Minor barriers such as difficulty determining patient eligibility (53.4%) and the patient’s willingness to receive the vaccine (44.8%) were identified.¹

An exploratory factor analysis of IBM SPSS, which was used to evaluate responses, determined 3 underlying barriers to pneumococcal vaccination, each including various subscales under their umbrella. These were financial, with a Cronbach’s alpha score of 0.696 and including the cost of vaccine stock and patient insurance coverage; lack of resources, with a Cronbach’s alpha score of 0.786 and subscales including lack of certified vaccine-administering staff and difficulty determining eligibility; and patient-related factors, with a Cronbach’s alpha score of 0.612 and subscales including patient demand and patient uncertainty of the vaccine’s effectiveness.¹

In a positive development, pharmacists reported being most confident in their practice’s ability to “coordinate tasks so that implementation of new vaccination services goes smoothly,” though they were least confident in their staff wanting to implement new services.¹

Immunizations are increasingly being received in community pharmacies. It will be critical for pharmacy leaders and their staff to ensure a robust framework for vaccinating patients against pneumococcal disease is in place, especially for high-risk patients. The investigators call for future studies that specifically investigate the willingness of staff to implement new vaccine services in their practice while addressing the low organizational readiness among pharmacists regarding pneumococcal vaccination.¹

“Pneumococcal vaccination guidelines change frequently, and it is difficult for pharmacists to stay knowledgeable about guideline recommendations,” the investigators wrote in their conclusion. “The lack of knowledge among pharmacists concerning pneumococcal vaccination recommendations highlights the need for immediate attention.”¹

REFERENCES

1. Davies A. Schreiber D, Carey C, et al. Community pharmacists' pneumococcal vaccine knowledge and perceived barriers to vaccination. Vaccine. 2025;53(19):126930. doi:10.1016/j.vaccine.2025.126930

2. Halpern L. Pneumococcal 21-valent conjugate vaccine generates positive response in adults at increased risk of disease. Pharmacy Times. Published October 21, 2024. Accessed April 8, 2025. https://www.pharmacytimes.com/view/pneumococcal-21-valent-conjugate-vaccine-generates-positive-response-in-adults-at-increased-risk-of-disease

3. Hung MC, Srivastav A, Lu PJ, et al. Vaccination coverage among adults in the United States, national health interview survey, 2021. Updated July 19, 2024. Accessed April 8, 2025. https://www.cdc.gov/adultvaxview/publications-resources/vaccination-coverage-adults-2021.html