Welcome to August! This is a busy month for many people, as it is time to revel in the last few weeks of summer and to prepare yourself or your children for school. As pharmacists, it is also an important month to establish changes in our scopes of practice within Missouri: August is National Immunization Awareness Month. Governor Nixon recently signed into law Senate Bill 754, which expands the ability to provide vaccinations under protocol. With this addition, pharmacists will be able to provide not only influenza, pneumonia, shingles, and meningitis vaccines under protocol, but also hepatitis A, hepatitis B, diphtheria, tetanus, and pertussis vaccines.1 In this exciting time of expanding opportunities, it’s important to not only prepare your pharmacy for the upcoming changes but to also advocate for your patient’s health care.
To become more familiar with the new vaccines and to re-familiarize pharmacists to the immunizations they already administer, some statistics are provided within this article about the national rate of immunizations. Healthy People 2020, a national initiative by the US Department of Health and Human Services, has set multiple goals to improve the health of the American population by the year 2020. A portion of the goals Healthy People 2020 are based around the intent to increase the rate of multiple types of immunizations and to reduce the rate of vaccine-borne illnesses.2 Pharmacists will be equipped to help our patients acquire certain immunizations that will put us on track for a healthier future.
- The National Immunization Survey in 2013 of teens aged 13-17, found that nationally 86% of those surveyed received one dose of Tdap since they were 10 years old, while in Missouri, 81.5% of those surveyed received a Tdap.3 Healthy People 2020 would like that number to be 80%, indicating that Missouri is right on target.2 Now that pharmacists will be able to administer diphtheria, tetanus, and pertussis vaccines, we should be able to further increase those numbers to stay on target for the 2020 goal.
- Hepatitis A and B are addressed in the Healthy People 2020 objectives as well, and a reduction in the development of new cases is targeted.2 Both hepatitis A and B are multi-dose vaccinations, and community pharmacists are likely to see their patients more often than at a doctor’s office, and pharmacists can be available to remind of an upcoming scheduled dose.4
- Healthy People 2020 would also like to decrease the rates of pneumococcal infection for those over the age of 65. In 2008, 60.1% of the population 65 years and older had received a pneumococcal vaccination; the goal for 2020 is 80%. In addition to the pneumococcal vaccination, Healthy People 2020 is targeting the shingles vaccine in patients 60 years and older. In 2008, 6.7% of the population 60 years and older were vaccinated against shingles; the target for 2020 is 30%.2 Pharmacists in community settings have a unique advantage to access to patients over the age of 60 who may either rarely visit the doctor’s office or who may run out of time to visit with the doctor, and with some questioning the pharmacist can ascertain the status of pneumococcal immunizations. Pharmacists may also be able to identify those patients under the age of 65 who may have risk factors requiring a pneumococcal vaccination.
- Of note for adolescents soon-to-be college-bound or others with risk factors or certain medical conditions, Healthy People 2020 would like to reduce the rate of meningococcal disease.2 According to the CDC, approximately 600-1000 people per year contract the disease; although this number isn’t staggering, the disease itself can be life-threatening.5 Those recommended to get the vaccination tend to be healthy individuals who may not be visiting the doctor very often. Having availability to a pharmacist outside of an appointment is a great way to meet the Healthy People 2020 goal.
- Last, but not least, on the list of the Missouri pharmacist administered immunizations: the influenza vaccine. Healthy People 2020 would like national rates of vaccination to increase. In Missouri, 46.4% of the population received an influenza vaccination during the 2012-2013 flu season, with the national average just below at 45%.6 The goal set for the general population is a 70% vaccination rate. Healthy People 2020 has set an even loftier goal for healthcare workers, with a target vaccination rate of 90%.2 Patients are generally aware that their local community pharmacist is equipped to administer the influenza vaccination, however many patients tend to brush off the need for the vaccine. Rand Health conducted a survey in 2011 to determine the attitudes of Americans not receiving the vaccine and found that many patients simply don’t feel they need the vaccine. Other popular responses included: not having time, not believing in the vaccine, and thinking that they may become sick from the vaccine.7 As health care professionals, pharmacists have a duty to their patients to help explain the need for the influenza vaccine. The CDC website also has handouts and brochures available for health professionals to distribute to patients.
Healthy People 2020 sets national goals for Americans that are achievable if all healthcare professionals work together to promote patient advocacy. Pharmacists in Missouri have just been armed with more tools at their disposal to ensure that patients are appropriately vaccinated; and although we may not be able to offer every vaccination, community pharmacists are uniquely positioned to provide patients with information about their health they may not otherwise receive.
MPA Rotation Student, August 2014
University of Missouri – Kansas City, MU site
Doctor of Pharmacy Class of 2015
- Missouri Senate. 97th General Assembly. Second Regular Session [Truly Agreed to and Finally Passed] Conference Committee Substitute for House Committee Substitute for Senate Substitute No. 2 for Senate Bill No. 754. http://www.senate.mo.gov/14info/pdf-bill/tat/SB754.pdf 2014. Accessed August 5, 2014.
- US Department of Health and Human Services. Healthy People 2020 Topics and Objectives: Immunization and Infectious Disease. http://www.healthypeople.gov/2020/ topicsobjectives2020/overview.aspx?topicId=23. Accessed August 5, 2014.
- Missouri Department of Health and Senior Services. National Immunization Survey: Teen (13-17 years old). http://health.mo.gov/living/wellness/immunizations/pdf/nationalsurvey-teen.pdf. Accessed August 5, 2014.
- Bridges CB, Woods L, Coyne-Beasley T. Advisory Committee on Immunization Practices: Recommended Immunization Schedules for Adults Aged 19 Years and Older; 2013.
- Centers for Disease Control and Prevention. Meningococcal Vaccination. April 1, 2014. http://www.cdc.gov/Vaccines/vpd-vac/mening/default.htm. Accessed August 6, 2014.
- Centers for Disease Control and Prevention. 2012-13 State and Regional Vaccination Trend Report. http://www.cdc.gov/flu/fluvaxview/reports/reporti1213/trends/index.htm. Accessed August 6, 2014.
- Adamson D. Rand Health Organization. Seasonal Flu Vaccine: Why Don’t More Americans Get It? 2011. http://www.rand.org/pubs/research_briefs/RB9572/index1.html. Accessed August 6, 2014.