U.S. adults suffer a high burden from disease for which vaccines are recommended, and vaccination coverage is low. For example, data from the 2011 National Health Interview Survey showed that only 12.5% of people aged 19 to 64 years got the Tdap (tetanus–diphtheria–acellular pertussis) vaccine, while only 29.5% of women aged 19 to 26 years received the HPV (human papillomavirus) vaccine.
On Monday during APhA2013, Erin Kennedy, DVM, MPH, Medical Officer at the CDC National Center for Immunization and Respiratory Diseases shared data on burden of vaccine-preventable disease and immunization coverage rates and noted that pharmacists are instrumental in driving CDC programs geared to improving vaccine uptake.
Fewer public health resources exist for adult immunization. Kennedy reported that from December 2010 to December 2011, pediatric purchases on federal contracts totaled $3,535 billion (including Vaccines for Children and Section 317 Immunization Program funds), whereas adult vaccine purchases totaled $44 million (317 Program funds only). Other barriers include competing social and economic demands among adults; competing demands for providers’ time, with vaccines often not integrated into adult medical care practice; the complexity of the adult vaccine schedule; and limited patient awareness and demand for adult vaccinations.
Many opportunities exist for raising awareness of adult immunizations and increase provider recommendations for adult vaccination. One such opportunity is PPHF (Prevention and Public Health Fund) Area 5: Plan and Implement Adult Immunization Programs. Made possible by the Affordable Care Act, PPHF Area 5 seeks to collaborate with employers to improve immunization among employees and work with pharmacies to improve immunization among adult patients. It will be operationalized through activities such as expanding adult immunization at community health centers, improving vaccine rates for health care workers, and increasing influenza and pneumococcal vaccinations at hospital discharge. Outcome measures for awardees of collaborative agreements will include the proportion and number of pharmacists trained to administer adult vaccines, proportion and number of pharmacists trained in using the state immunization information system, and the number of vaccine doses administered by pharmacists entered into the registry.
CDC’s request of pharmacists is to ensure that patients visiting pharmacies or clinics are aware of recommended vaccinations, assess patients’ vaccine needs, and, if possible, offer them needed vaccines. An example noted by Kennedy is for pharmacists to inform pregnant women that they should receive the Tdap vaccine after week 20 of pregnancy and the influenza vaccine anytime during pregnancy.
Pharmacists are in a great position to improve vaccination in people with high-risk conditions, such as diabetes, asthma, and cardiovascular disease. “You know what prescriptions they are getting and what their health conditions are, so you have a great opportunity to improve immunization rates among these higher-risk individuals,” said Kennedy.
CDC offers a wealth of resources for educating adult patients about vaccines. These include posters, tear sheets, and a recommended vaccines prescription pad.
“We at CDC believe that pharmacies should be integrated as key community partners in vaccination efforts and emergency response,” said Kennedy.