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Study: Pharmacies' flexible hours spur vaccinations
September 11th, 2013
NEW YORK – One of community pharmacy's strongest attributes — convenience — is playing a pivotal role in boosting U.S. immunization rates but could do even more, according to a Walgreen Co. study published in the September/October issue of Annals of Family Medicine.
The study assessed the implications for improving patient access to vaccinations and the potential to reduce vaccine-preventable diseases, from which 50,000 adults die annually in the United States, including 23,000 deaths from influenza.
A key focus of the research was the fact that most traditional vaccine providers — namely doctor's offices — administer immunizations during standard clinic hours, whereas community pharmacies offer expanded hours that enable patients to be vaccinated at more convenient times.
"Community pharmacies are uniquely positioned to increase immunization rates in the United States," stated the report, titled "Vaccinations Administered During Off-Clinic Hours at a National Community Pharmacy: Implications for Increasing Patient Access and Convenience."
The study's authors were Michael Taitel, senior director of clinical outcomes and analytic services at Walgreens; Leonard Fensterheim, manager of health outcomes and analytics at Walgreens; Adam Cannon, an analyst for clinical outcomes and analytics at Walgreens; and Jeffrey Goad of the University of Southern California School of Pharmacy and
Researchers reviewed data for all vaccinations given at Walgreens drug stores between August 2011 and July 2012. The time of vaccination was categorized as occurring during traditional hours (9 a.m. to 6 p.m. weekdays) or off-clinic hours, consisting of weekday evenings, weekends and federal holidays. Demographic characteristics and types of vaccines also were compared.
The study found that during that time span, Walgreens pharmacists provided more than 6.25 million immunizations, of which 30.5% were provided during off-clinic hours (17.4% on weekends, 10.2% in the evening and 2.9% on holidays). Patients getting immunized during off-clinic hours tended to be younger than age 65, male, urban residents and without chronic health conditions.
Of those patients receiving vaccinations, 85% were for flu and 15% were for other vaccine-preventable diseases, such as shingles, pneumonia, tetanus/diphtheria/pertussis (Tdap), meningitis, hepatitis A/B, human papillomavirus (HPV), measles/mumps/rubella (MMR) and chicken pox.
“This study clearly underscores the valuable role that our community pharmacies can play in providing greater access to vaccines, which can be a key contributor to better immunization rates,” Taitel said in a statement.
Adult immunization rates for vaccines recommended by the Centers for Disease Control and Prevention (CDC) range from a low of 14% for the shingles vaccine to a high of 64% for the tetanus vaccine (the rate for the Tdap vaccine is 8.2%), the report said. Adult flu vaccination rates vary widely but average just 40.5%, with seniors having the highest rate (69.6%).
"Unfortunately, pharmacists' ability to fully enhance vaccination rates is limited by a patchwork of state laws that allow either unrestricted authority to administer vaccines or a variety of restrictions," the study noted.
For example, 41 states/territories let pharmacists give any vaccine, but 17 restrict pharmacist-provided immunizations to patients ages 18 and older. All 50 states, the District of Columbia and Puerto Rico now allow pharmacists to give flu vaccinations to all
adults. The report noted that a 2004 study showed that as more states allowed pharmacists to vaccinate, the immunization rates for those states were higher than the rates in states that didn't do so, suggesting pharmacists weren't just shifting patient populations from medical clinics, but identifying new populations.
"Expanding the ability of pharmacists to administer all vaccines to adolescents and adults in all states without a physician prescription, coupled with expanded hours of operation, is likely to have the greatest impact on pharmacy based immunization rates," the study concluded.