Prepare for Autumn Immunizations

According to a CDC study, pharmacies were the most common health care settings where patients received influenza, updated COVID-19, and respiratory syncytial virus (RSV) vaccines during the 2023-2024 respiratory virus season.1 This highlights pharmacists’ critical role in fall immunizations through medication therapy management (MTM). The CDC issued a health advisory in December 2023 regarding the vital need to increase flu, COVID-19, and RSV vaccination rates to prevent hospitalizations and deaths,² and this need continues into the upcoming season. Through vaccine education and administration, pharmacists can help improve immunization rates during the 2024-2025 respiratory virus season.

Image credit: Daniel Jędzura | stock.adobe.com

Fall Vaccines and MTM

Pharmacists should be aware of several critical updates regarding fall vaccines (Table^3,4). More than 75,500 individuals died from COVID-19 in 2023, and approximately 45,000 died from influenza-related complications during the 2023-2024 flu season.³ Vaccines provided at pharmacies can play a significant role in decreasing those statistics.

In line with last year’s guidance, the CDC recommends that everyone 6 months and older receive an updated 2024-2025 COVID-19 vaccine.³ In August 2024, the FDA approved and authorized Pfizer and Moderna's updated 2024-2025 COVID-19 vaccines.4 Research showed that patients who received the updated 2023-2024 COVID-19 vaccine were better protected against illness and hospitalization.³ Sharing this information and giving a trusted recommendation can help indecisive patients decide to get vaccinated.

Influenza vaccines are recommended for individuals 6 months and older.³ One unique difference for the 2024-2025 season is that the influenza vaccines will be trivalent and protect against a novel influenza A (H1N1), influenza A/New York/55/2004 (H3N2), and a B/Victoria lineage virus.³

There are also notable updates for RSV vaccine recommendations. One is removing the shared clinical decision-making (SCDM) process to provide stronger guidance. The updated recommendation is designed to simplify decision-making for clinicians and patients.⁵ The CDC recommends that everyone 75 years and older receive 1 RSV vaccine based on data that a single vaccination provides coverage over multiple seasons.⁶ Individuals aged 60 to 74 years should receive 1 vaccine if they are at higher risk of RSV.6 This includes individuals with chronic cardiovascular or pulmonary diseases and patients in long-term care facilities.6 The optimal time for RSV vaccination is late summer and early fall before RSV season typically starts.⁶

Pharmacists can also positively impact immunizations through vaccine assessment and patient education. One study evaluated the impact of implementing a vaccine questionnaire along with pharmacist-led patient counseling on unmet vaccination needs.⁷ The vaccine assessment form (VAF) was created by Walgreen Co, based on CDC recommendations for addressing unmet needs and enhancing knowledge about immunizations. 7 Point-of-care screening through a questionnaire can serve as an essential tool.

In the study, 5 pharmacists provided patient counseling and identified unmet immunization needs.7 The study revealed that 133 patients visited the pharmacy to receive vaccines and completed the VAF.⁷ Pharmacists identified 126 unmet immunization needs, the most common being influenza vaccines (n=37).7 The most common outcome was a vaccine referral (69%) made for a later date.⁷ Cost (68%) was the most significant factor for delaying the vaccine.7 About 14% of the unmet vaccination needs discovered were administered at the same visit.⁷ The study showed that a VAF combined with pharmacist-led patient counseling addressed unmet vaccine needs and closed immunization gaps.⁷Addressing unmet vaccine needs is a critical part of MTM.

REFERENCES

1. National and state-specific estimates of settings where adults received influenza, updated COVID-19, and RSV vaccinations, 2023-2024 respiratory virus season, United States. CDC. Updated June 10, 2024. Accessed August 5, 2024. https://www.cdc.gov/vaccines/imz-managers/coverage/national-state-vaccination-estimates.html

2. Urgent need to increase immunization coverage for influenza, COVID-19, and RSV and use of authorized/approved therapeutics in the setting of increased respiratory disease activity during the 2023-2024 winter season. CDC. December 13, 2023. Accessed August 5, 2024.https://emergency.cdc.gov/han/2023/han00503.asp?utm_source=MarketingCloud&utm_medium=email&utm_campaign=PT+Daily+Dec152023&utm_content=PT+Daily+Dec152023

3. CDC recommends updated 2024-2025 COVID-19 and flu vaccines for fall/winter virus season. News release. CDC. June 27, 2024. Accessed August 5, 2024. https://www.cdc.gov/media/releases/2024/s-t0627-vaccinerecommendations.html

4. FDA approves and authorizes updated mRNA COVID-19 vaccines to better protect against currently circulating variants. News release. FDA. August 22, 2024. Accessed August 28, 2024. https://www.fda.gov/news-events/press-announcements/fda-approves-and-authorizes-updated-mrna-covid-19-vaccines-better-protect-against-currently

5. CDC updates RSV vaccination recommendation for adults. News release. CDC. June 26, 2024. Accessed August 5, 2024. https://www.cdc.gov/media/releases/2024/s-0626-vaccination-adults.html

6. Respiratory syncytial virus (RSV) immunizations. CDC. Updated July 3, 2024. Accessed August 5, 2024. https://www.cdc.gov/vaccines/vpd/rsv/index.html

7. Lilly R, Dang L, Frangello J, Roque D, Liu Y. Impact of pharmacist-led vaccine assessment and patient counseling on unmet vaccination needs in the community pharmacy setting. JAPhA Pract Innovations. 2023;1(2):100004.doi:10.1016/j.japhpi.2023.100004