Pharmacists Skilled at Persuading Patients to Get Flu Shots

Pharmacy-driven education can increase immunization acceptance among hospitalized patients refusing flu or pneumococcal vaccination upon admission.

This finding is especially relevant considering that influenza vaccination in the 2012-2013 flu season reduced hospitalizations by 17%, prevented 6.6 million influenza cases, and 3.2 million medically attended illnesses. In addition, influenza often leads to pneumonia—the most deadly vaccine-preventable disease in the United States—in compromised patients.

The majority of pneumococcal disease deaths occur in patients who should or could have been vaccinated with the pneumococcal polysaccharide vaccine. Although 62.3% of adults aged 65 years or older receive the vaccine, only 20.3% of indicated patients younger than 65 years do so.

However, findings from a study published in the Journal of Pharmacy Practice show that pharmacy-driven education can persuade patients to get their flu or pneumococcal vaccines, even after they initially refused to accept them.

The study authors flagged vaccination refusal from a nurse at admission, at which point a pharmacist or pharmacy intern was notified to provide patient education the next day. This education program excluded critical care and surgical patients, nonindicated and contraindicated patients (per the Advisory Committee on Immunization Practices), and mentally incompetent patients.

Pharmacy-provided education increased influenza and pneumococcal vaccination by 23.4% and 26.5%, respectively, in a total of 297 interventions. Patients were most likely to accept influenza vaccination at the beginning or peak of flu season, but pneumococcal vaccine acceptance did not follow any discernible pattern.

Some patients described themselves as “undecided” even after receiving pharmacy-provided education (15.9% for influenza vaccination and 19.3% for pneumococcal polysaccharide vaccination). The researchers believed that follow-up would capture some of these undecided patients.

Approximately 1 in 3 patients did not wish to disclose why he or she refused vaccination.

The program drafted standardized forms for influenza and pneumococcal vaccination, but the verbal persuasiveness of each pharmacist and student varied. Influenza vaccination acceptance may have been decreased because the 2014-2015 influenza vaccine was widely reported to be ineffective.

This was the first study to examine pharmacists’ impact on improving vaccination among initial refusers. Repeating it could produce better results if the program starts in September, rather than October, documents the original reason for refusal, and targets the pharmacy-driven education to address the patients’ specific beliefs.