Pharmacists: Quiet, but Mighty, Immunization Champions

The Impact of Immunizations

Immunizations are critical to the health and well-being of our communities; but as people were quarantined during the pandemic, routine immunizations for both children and adults were postponed. According to an analysis of insurance claims by healthcare consulting firm Avalere, adults and adolescents have missed more than 37 million routine vaccinations during the COVID-19 pandemic. They compared vaccination claims from January 2020 through June 2021 against baselines from 2019 and found monthly claims were down 32% for adults and 36% for adolescents. This is not only alarming, but economically problematic for the U.S. Routine vaccinations against such diseases as diphtheria, tetanus, pertussis, hepatitis B, meningitis, and others are critical to positive health outcomes and lower healthcare expenditures. In a report published by the organization Vaccinate Your Family, for every $1 spent on childhood vaccinations, our country saves $10.90. The CDC estimates that for the vaccination of children born between 1994 and 2018, the U.S. has saved nearly $406 billion in direct medical costs and $1.88 trillion in total society costs. This financial impact does not stop with children. The country spends nearly $27 billion annually treating vaccine preventable diseases in our adult population as well. In order for vaccines to work, they first have to be administered to the patient. Who better to assist with this process than the most visible and accessible community health provider: your local pharmacist!

Immunizations and your local pharmacist

Pharmacists are uniquely qualified to provide immunizations; they are, after all, medication experts and must be certified to provide immunizations. Since 90% of Americans live within five miles of a pharmacy―and most retail pharmacies are open extended hours―they are also more convenient than most healthcare providers. As evidence of pharmacists’ accessibility, during the COVID-19 pandemic more than 250 million doses of COVID-19 vaccine have been administered by retail pharmacies; that is about 42% of all the doses administered in the U.S.

Roles are expanding

Pharmacists are not new to immunizing. Immunization certification programs for pharmacists began in the late 1990s and have been expanding ever since. State boards of pharmacy started regulating the service, and as the demand for immunization services changed so did the regulations. Some states allow almost complete autonomy for their pharmacists, while other states are more restrictive, requiring pharmacists to enter into collaborative practice or protocol-type agreements with physicians in order to immunize. When COVID-19 hit the U.S., the federal government quickly realized the need for large-scale vaccinations and turned to pharmacists to fill that void. The first Public Readiness and Emergency Preparedness (PREP) Act declaration was put in place against COVID-19 on March 17, 2020, and later amendments provided pharmacists, pharmacy interns, and pharmacy technicians the ability to immunize against COVID-19. This proved so successful that when the U.S. started to see a decline in routine immunizations, this group was then called upon to vaccinate a larger age group with an expanded number of vaccinations. Because the PREP Act is an emergency declaration, it has an expiration date. States recognized the benefits of allowing these expanded services provided by pharmacists, interns, and techs and began to memorialize their role expansions into state regulations. When the FDA recently updated a COVID antiviral medication’s EUA to allow pharmacists to prescribe, this too was a big win for pharmacists. But unfortunately, challenges still exist.

Immunization services challenges

Providing immunization services certainly comes with some challenges for the pharmacy. These include knowing the complex state and federal regulations to understand who can immunize what set of patient populations with which products―keeping up with the ever-changing CDC’s Advisory Committee on Immunization Practices (ACIP) recommendations―and ensuring the immunizer is properly trained, credentialled, and certified (and that those items are up to date), all of which happens before the immunization process can even begin! Solving workflow considerations such as a dedicated immunization area, product storage and temperature management, pharmacy labor, patient scheduling, and reporting to immunization registries are all critical to the success of a pharmacy’s immunization service. The goal of any immunization service should be to keep the patient up to date with routine immunizations, and that may be the trickiest and most time-consuming aspect for the pharmacy staff. Thankfully, Change Healthcare has a solution.

Change Healthcare’s Converge Rx clinical platform

Change Healthcare’s Converge Rx clinical platform is workflow-integrated to perform, record, and bill for immunization services. It is designed to assist the pharmacist in accomplishing more business while improving patient care. Converge Rx can help increase revenue through eligibility and targeting programs, and gain visibility into additional vaccination opportunities via immunization history and forecasting. The platform offers seamless reporting of vaccinations to immunization registries to maintain compliance and lighten the burden of the pharmacy staff. According to Robbert Ayshford, a registered pharmacist and vice president of new business development for Pharmacy Solutions at Change Healthcare: “The Converge Rx clinical platform is integrated into the pharmacy workflow and helps overcome some of the challenges of providing immunization services. Our targeting algorithms allow the pharmacist to have a conversation with your patient on the immunizations they should receive.” Converge Rx is a timesaver for the pharmacy staff and could be a lifesaver for patients.