Pharmacists are Becoming Valuable Public Health Partners During Flu Season

In the United States, pharmacists trained to provide immunization delivery has grown from 40,000 in 2007, to more than 260,000 in 2015. According to the Centers for Disease Control and Prevention (CDC), “by 2016, all accredited schools of pharmacy in the US will be required to include immunization training of student pharmacists as part of their core curricula.”

Pharmacists are critical to expanding access to pandemic vaccination. However, little is known about the relationships and planning activities between public health programs and pharmacies. A recent paper analyzed data from the CDC to assess those jurisdictions that received immunization and emergency preparedness funding between 2012 to 2015.

In total, out of the 53 jurisdictions that were assessed, 47 (88.7%) reported they included pharmacies in pandemic vaccine distribution. In addition, approximately 45% had plans to recruit pharmacists to vaccinate and 30.8% had begun to establish formal relationships with pharmacists. The researchers found, “While most jurisdictions plan to include pharmacies as pandemic vaccine providers, work is needed to establish formalized agreements between public health departments and pharmacies to improve pandemic preparedness coordination and ensure that vaccinating pharmacists are fully utilized during a pandemic.”

Pharmacists have expanded their authority throughout the United States to vaccinate, particularly against influenza. As a result, pharmacists in every state, as well as those in the District of Columbia and Puerto Rico, are becoming increasingly familiar with vaccine management and delivery. Currently, one in four adults receive their seasonal “flu-shot” in a pharmacy or other retail setting.

Despite the progress being made, overall vaccination rates for adults in the United States remains low and racial and ethnic disparities in coverage persist. To address these challenges, the CDC encouraged pharmacists to support “immunization neighborhood,” and implement National Vaccine Advisory Committee Standards for Adult Immunization Practice.

In order for pharmacies to become ready to provide vaccinations, specifically influenza, in the event of a severe pandemic, they must understand the logistical differences between planning for both seasonal and pandemic influenza. Typically, pharmacists prepare for seasonal influenza by ordering vaccinations through their vendor. However, providers who wish to administer vaccinations during a pandemic must coordinate and enroll with their local public health program. Allocation depends upon patient population size and demographics, as well as storage and handling capabilities; this means that pharmacists must coordinate with public health officials well in advance.

According to the public health data collected, most programs view pharmacies and pharmacists as valuable public health partners and have plans to include pharmacists as vaccinators, though there have been some identifiable gaps that remain.

Most often, there is incomplete information regarding the community population. A lack of clarity pertaining to enrollment and outreach as well as limited storage and handling capacity also make rapid vaccine allocation decisions challenging. Additionally, issues regarding uninsured patients have not been clarified. The authors of the report concluded, “perhaps the biggest pandemic vaccine program planning gap is that most public health programs appear to be underestimating the value and potential vaccination capacity pharmacies and pharmacists might have in rapidly vaccinating the public during a pandemic.”

Pharmacies currently provide approximately 25% of seasonal influenza vaccine to adults during flu season. The researchers believe including pharmacies during pandemic influenza vaccine campaigns, despite high levels of participation from other vaccinators, can reduce the time it takes to vaccinate 80% of US adults with a single dose, from 18 weeks to 11 weeks.

As of September 2016, a pilot program has begun in three states to solidify partnerships between pharmacists and public health programs. The CDC and Association of State and Territorial Health Officials, are working with their immunization and preparedness partners to disseminate and raise awareness of available preparedness tools.