Pharmacists can now play an even greater role in improving public health, not only by educating and advocating about the importance of immunizations but also providing them. Over two decades the ability of pharmacist to provide immunizations has grown tremendously, in 1994 Washington was the first state to give community pharmacists the authority to vaccinate the public and in 2009 Maine was the final state to approve influenza vaccine administration by pharmacists. Now all 50 states allow pharmacists to vaccinate the public, although training and certification requirements, types of vaccines allowed, patient ages, collaborative practice agreement requirements and other intricacies vary by state. Refer to your state practice act and board of pharmacy for specific details.
While pharmacists nationwide may be providing influenza vaccinations, a greater opportunity exists to improve public health and pharmacy profits by expanding vaccination services year-round. Where allowed by law, increasing the number of and types of vaccinations provided may help to increase store traffic, pharmacy and front-end sales as well as elevate the perception of your pharmacist immunizers by both patients and other health care providers in your community.
In June 2009, the Task Force on Preventative Services identified three ways to implement continual vaccination services in the community including: increase demand, improve accessibility, and reduce missed opportunities.
In order to increase demand by existing pharmacy customers and potential new clients, they have to know about the availability of immunizations at the pharmacy. All pharmacy staff including pharmacists and pharmacy technicians should be trained regarding the services your pharmacy offers including types of vaccines as well as prices and insurance(s) accepted if applicable. All staff should know basics about what is offered, as well as schedule of when they will be offered or how to schedule appointment, if applicable. Pharmacy technicians should also know when to refer patients with additional questions or potential contraindications to receive the vaccine to the pharmacist for counseling. Even if not all pharmacists are immunizers, they should still be trained to answer patient questions regarding if the vaccine would be indicated or contraindicated depending on patient specific characteristics including age, health status, risk factors, etc.
Make a display or flyer to post in the pharmacy and community regarding your immunization services. Consider creating a brochure or pamphlet that can be provided to new and regular pharmacy customers regarding immunization services offered. A bag stuffer with information on services and/or a coupon may be helpful.
If not already in place, consider a collaborative practice agreement or standing order from a local physician for vaccines offered. Also, alert and educate other local health providers of the services the pharmacy offers. They may be willing to refer patients to the pharmacy for vaccination. Reach reaching out to local employers or nursing homes in your community to offer your immunization services, not only for influenza season but also beyond.
Pharmacists are one of the most accessible healthcare providers, and arguably the most accessible when it comes to providing immunizations. Every day patients that could benefit from immunizations pass through the pharmacy doors however may not be aware of their individual immunization needs or that the pharmacy offers the services. Or they may not be aware that their child or other family member, co-worker, or friend is in needs of immunizations and could easily access them at your pharmacy. Educating your patients and community as much as possible about the types of immunizations available as well as who needs them can help to improve accessibility to year-round immunization services.
Reduce Missed Opportunities
Reducing missed opportunities is critical to increasing immunization rates and your immunization business. When patients come to the pharmacy or make purchases in the front-end of the store it’s a perfect opportunity for the pharmacy staff to inquire about their need for immunizations. Even asking patients a simple question regarding if they have received a specific vaccination or whether they are aware that your pharmacy offers immunizations and reinforcing how critical it is to be up-to-date on immunizations. Often customers may think of immunizations as something that children need, but it’s important to educate them about the needs for immunizations as adults, in the elderly or specialized needs for overseas travelers. If your pharmacy participates in community events or health fairs marketing as well as providing immunizations (if allowable) is another opportunity to expand your business while improving public health.
An additional approach to reducing missed opportunities is focusing on partnerships among health professionals. For example, a physician with whom you may have a standing order could refer eligible patients. Some physician offices may choose not to carry a certain vaccination(s) due to storage, reimbursement, or staffing issues which may open up an opportunity for referral. Don’t forget to educate other health professionals in the area when you offer or add an additional immunization service.
Looking at patient specific characteristics, such as age and disease states, if applicable may open up the door to more tailored patient counseling regarding immunizations. Your pharmacy team may help identify potential patients who are in need of additional vaccinations (remember all potential candidates would need to be further screened including identifying any potential contraindications). For example pharmacy staff could look at specific populations like college students and recommend vaccination against human papillomavirus (HPV) or meningococcal disease, if indicated. Also consider educating new parents or caregivers for young children regarding the importance of tetanus, diphtheria, and pertussis (Tdap) vaccination and immunizing eligible patients. Conversely, you could have pharmacy initiatives focused around certain vaccines or more than one vaccine such as the following examples.
- Herpes zoster vaccine
- Discuss it’s availability with all patients over the age of 50
- Educate patients as well as local health care providers that the vaccine itself is often covered by Medicare Part D
- Pneumococcal polysaccharide vaccine (PPSV)
- Recommend it to all patients age 65 and older, if they have never received or if they received prior to age 65 (a single revaccination may be indicated)
- Educate all adults 19-64 who are smokers or who have asthma that they also need vaccination.
- Raise awareness that anyone ages 2-64 who has a long term health problem (heart disease, lung disease, diabetes, alcoholism, etc.) or disease or condition that lowers the body’s resistance to infection (such as organ transplant, HIV/AID, etc.) should also receive PPSV
There are numerous examples like the above for other vaccines that may be offered at the community pharmacy (if allowed by state law), such as HPV, meningococcal, tetanus, hepatitis A, hepatitis B vaccines and several more. Refer to the Centers for Disease Control Advisory Committee on Immunization Practices (ACIP) recommendations and guidelines for each vaccine as well as vaccine administration which can be accessed at http://www.cdc.gov/vaccines/recs/acip/default.htm. A Vaccine Information Statement (VIS) should be provided to every patient for review prior to the administration of any vaccine, but they can also be a helpful resource for pharmacy staff on who would benefit from a specific vaccine. Downloadable VISs are available from the CDC at http://www.cdc.gov/vaccines/hcp/vis/index.html and the Immunization Action Coalition is also a helpful resource for VISs in a number of languages, go to http://www.immunize.org/vis/.
Call to Action
Providing year-round immunizations services is a great opportunity to simultaneously help improve health outcomes while increasing pharmacy revenue. Take the first step to providing year-round immunizations with your pharmacy team today by making a plan to increase demand, improve accessibility, and reduce missed opportunities. Begin today by planning what expanded immunization services you would like to offer and educate the pharmacy team to enable effective patient outreach.
To download a copy of this article, click here: Creating a Year-Round Immunization Business