Vaccinating pediatric patients requires preparation, planning

In August, HHS announced that it expanded pharmacists’ authority to immunize children ages 3 to 18 years with vaccines recommended by CDC’s Advisory Committee on Immunization Practices (ACIP) and authorized or licensed by FDA. This will include the COVID-19 vaccine.

HHS is counting on pharmacists to help boost access and administration of childhood vaccines at a time when individuals and communities need protection from vaccine-preventable diseases. Earlier this year, CDC reported that rates of childhood immunizations had sharply declined nationwide as a result of the pandemic.

Pharmacists across the country now have the ability to immunize pediatric patients during the COVID-19 public health emergency. The authority applies to pharmacists in all states, regardless of regulations restricting pharmacists from administering specific vaccines or limiting the age groups they may immunize. Pharmacy interns and technicians who meet HHS requirements can administer childhood and COVID-19 vaccines as well.

However, some barriers exist in getting pharmacists fully integrated into the nation’s framework of childhood vaccinations. Namely, few pharmacies are enrolled in the Vaccines for Children (VFC) program. According to Rebecca Snead, RPh, executive vice president and CEO of the National Alliance of State Pharmacy Associations (NASPA), fewer than 100 pharmacies in the United States are enrolled in the VFC program.

Over half of children in the United States are eligible to receive vaccinations through the VFC program. This includes children who are Medicaid-eligible, uninsured, underinsured, American Indian, or Alaskan Native. Under the VFC program, CDC purchases ACIP-recommended vaccines from manufacturers and distributes them to grantees, such as state health departments, who then partner with physicians’ offices or pharmacies who are registered VFC providers. Health care practitioners must be recognized by the VFC program in order to receive payment for the administration of the vaccine.

For all providers participating in the VFC program, Snead said the main barrier is in the onerous enrollment process, which is essential for payment for the administration of the vaccines.

In addition, many private insurers that cover the rest of the childhood population have not enrolled pharmacists as providers on the medical benefit where these vaccines are routinely reimbursed for other providers.

“There is a time delay to get pharmacists enrolled in networks,” said Snead.

NASPA and other pharmacy associations are working through these roadblocks so that pharmacists, pharmacy interns, and pharmacy technicians can provide vaccinations to children.

APhA worked with a coalition to develop three tools pharmacists can use to be compliant with the pediatric immunization patient/caregiver education requirements in the HHS authority. There are three forms pharmacists can give patients—a referral form, a well-child visit brochure, and a template letter to be given to the patient (all can be found here).

For the full article, please visit for the December 2020 issue of Pharmacy Today.