Report Outlines Pharmacists’ Essential Role in Vaccinations

A new report from IQVIA outlines the vital role that pharmacists play in vaccinations, particularly during and after the COVID-19 pandemic.

During the COVID-19 pandemic, legislators made multiple amendments to the Public Readiness and Emergency Preparedness (PREP) Act, including identifying an additional category of “qualified persons” who can order and administer any vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) for patients aged 3 through 18 years. By October 2020, pharmacists and pharmacy interns were authorized nationwide to administer childhood vaccines, COVID-19 vaccines, and COVID-19 tests, vastly expanding their role in the pandemic response.

“The PREP Act declarations remain in effect until 2024 unless [the Department of Health and Human Services] terminates them sooner. Currently, 25 states have given permanent vaccination authority to pharmacy technicians while others do not provide permanent authority but may allow authority for certain vaccines under specific conditions,” the authors wrote in the report. “As pharmacies have played a crucial role in the administration of COVID-19 and flu vaccines during the pandemic, it is worth assessing the role of pharmacy technicians to understand the importance of providing permanent authority to them.”

The report noted that pharmacists are the most accessible health care professionals in the country, with approximately 90% of the US population living within 5 miles of a community pharmacy. Earlier studies have found that the median number of visits to community pharmacies was significantly higher than encounters with primary care physicians for Medicare patients, and a more recent study found that there were 15.1% more pharmacy locations within low-income communities than physician practices.

Across all vaccines for adults in the scope of the IQVIA analysis, researchers found that a significant majority of the administration took place at pharmacies compared to non-pharmacy medical settings. In addition, 2020 and 2021 saw a major increase in vaccine administration at pharmacies as patients sought COVID-19 vaccines. Excluding temporary and government public health sites, more than 90% of COVID-19 vaccines provided through either medical centers or pharmacies were delivered at pharmacies.

The increase in pharmacy-administered vaccinations was noted regardless of gender, race or ethnicity, or income. Other adult vaccines were also a substantial proportion of administrations at pharmacies. For example, the researchers found that the shingles vaccine had a large majority of administration taking place at the pharmacy level across all the years analyzed.

Pharmacies have always played an important role in flu vaccinations, and that role has also increased in recent years. The report noted that between 60% and 70% of flu vaccines during any flu season will take place at pharmacies. The trends in flu vaccine administration at pharmacies also suggest a 30% to 40% increase in claims for flu vaccines between 2018-19 and 2020.

Many pneumococcal vaccines are also administered at pharmacies. In the third and fourth quarters of any given year, between 40% and 50% of pneumococcal vaccine administration occurs in a pharmacy setting. The overall number of claims also consistently increases in these quarters each year, which could be attributed to the annual flu season and increased patient awareness of vaccines, as well as opportunities for providers to educate patients about pneumococcal vaccination.

Like adults, a large majority of COVID-19 vaccines were administered to children at the pharmacy level, excluding temporary and government public health sites.

As the COVID-19 pandemic enters a more endemic period and the US health care system looks to the future, the report said lessons learned from the pandemic must be incorporated in future policies. Any successful policies must include equitable access to vaccines, and pharmacies can be a key player in those efforts.

“The efforts to promote equitable immunization have accelerated during the COVID-19 pandemic,” the authors wrote in the report. “These efforts have highlighted the importance of considering the intersectional relationship between access to health care and socio-economic status, race, ethnicity, and other social and structural determinants of health.”

The report suggested several approaches to achieve equitable vaccine access, including codification of the PREP Act and subsequent changes to state and federal laws to ensure that the current approaches are not impacted. Additionally, the report said appropriate reimbursement for all health care professionals who provide immunization services would encourage their ongoing provision of vaccines.

The report authors added that assessments should be performed of the impact of increasing and enhancing state laws governing pharmacists’ authority. Allowing pharmacists to administer all FDA-approved and ACIP-recommended vaccines would provide evidence for relevant stakeholders to assess such changes, the report said.

REFERENCE

Trends in Vaccine Administration in the United States. IQVIA; January 2023. Accessed February 1, 2023. https://www.iqvia.com/insights/the-iqvia-institute/reports/trends-in-vaccine-administration-in-the-united-states