Journal of Vaccines & Vaccination

Enhance and Expand Access to Vaccines

Robert Popovian^1* and Dave Hering^{2 1}Department of Pharmacy, University of Southern California, Vice-President US Government Relations, Pfizer Inc., North America, USA
²Department of Pharmacy, University of Liverpool, Regional President, North America, USA
^*Correspondence: Robert Popovian, Department of Pharmacy, University of Southern California, Los Angeles, North America, USA, Tel: +18184540497, Email:

Received: 21-Oct-2020 Published: 11-Nov-2020, DOI: 10.35248/2157-7560.20.S5:006

Description

It was not so long ago and certainly within the memory of many older Americans, when the fear and uncertainty we are experiencing today with coronavirus were much more common. Before the advent of vaccines for a vast number of diseases, it was not uncommon for people to know friends and family members who had contracted measles, mumps, rubella or polio. Families routinely had to deal with the impact of these diseases on everyday life and, more significantly, manage life-long disabilities like loss of vision, hearing or mobility.

There are scores of studies on the positive impact that vaccination has had on public health. In addition, vaccines are one of the most cost-beneficial interventions in health care. It is estimated that caring for unvaccinated adults costs the U.S. health care system approximately $7 billion per year [1].

Vaccination rates in the United States for most serious ailments are in the 90^th percentile for children, while for adults, the immunization rates are abysmal. For example, less than 50 percent of adults age 19 and older get flu shot every year [2]. What’s even more alarming is that for adult patients between the ages of 18 and 65 with risk factors (e.g. patients with asthma or chronic bronchitis or smoking history), the rate of pneumococcal vaccination is only 23 percent [3]. Both measures are well below the Healthy 2020 targets set by the U.S. Office of Disease Prevention and Health Promotion.

One approach to encourage adult vaccination is to further expand the ability of community-based pharmacists to administer vaccines [4]. Patients and health systems have benefited most when pharmacists are allowed to immunize patients.

Roughly 9 out of 10 Americans live within 5 miles of a pharmacy that provides vaccination services to patients without an appointment [5]. Community pharmacies offer extended hours of service compared to other sites-of-care, which is especially important for younger, healthier adults for whom immunization rates are exceptionally low.

Also, the evidence is clear that allowing pharmacists to administer vaccines is the lowest-cost alternative for providing this essential public health service. For the most vulnerable adults, our seniors, there may be additional access issues because a majority of family physicians either aren’t stocking or are unable to bill for all available vaccines, especially those reimbursed under Medicare Part D.

Unfortunately, there are significant variations in state laws governing pharmacists’ ability to immunize patients. States that have more restrictions on pharmacists’ ability to provide vaccinations may negatively affect public health and increase health care costs. Therefore, it is of utmost importance for states to expand and harmonize state laws governing pharmacist authority to immunize and allow pharmacists to administer all Food and Drug Administration-approved and Advisory Committee on Immunization Practices (ACIP) recommended adult vaccines.

The recent guidance from Health and Human Services (HHS) allows pharmacists to administer any COVID-19 vaccine, which is FDA-authorized or FDA-licensed, is a step in the right direction [6]. However, the HHS direction under the Public Readiness and Emergency Preparedness Act (PREP Act) is time-limited and mandates that it be based on ACIP recommendation.

Reducing vaccine-preventable disease prevalence and overall health care costs is critical for all Americans. The best way to achieve both goals is through increased vaccination of adults in the United States, particularly at the pharmacy. Policymakers must take the important step of implementing state laws to expand pharmacists’ immunization authority for adults, so we are better prepared if and when the next public health crisis occurs.

REFERENCES

1. Ozawa S, Portnoy A, Getaneh H, Clark S, Knoll M, Bishai D, et al. Modeling the economic burden of adult vaccine-preventable diseases in the United States. Health Aff. 2016; 35(11):2124-2132.
2. Vaccination coverage among adults in the United States, national health interview survey-2016. CDC. 2018.
3. Olasupo O, Segal R, Brown J. Missed opportunities for pneumococcal vaccinations in high-risk and older adults in the United States. J Infect Public Health. 2020; 13(1):101-103.
4. McCombs J, Dang R, Seo RY, Nguyen E, Limbo JC, Lam J, et al. Is the U.S. Ready to Quickly Vaccinate Its Population Against COVID-19. USC. 2020.
5. Kelling SE, Pattin A, Salim A, Kilgore P, Erickson SR. Cross-sectional survey of perceived barriers among community pharmacists who do not immunize, in Wayne County, Michigan. J Infect Dis Ther. 2016; 5(4):525-533.
6. Trump Administration Takes Action to Expand Access to COVID-19 Vaccines. HHS Gov. 2020.