Fortifying Pharmacy-Based Access to Adult Vaccines: Current State Policies and Best Practices
Adult vaccination rates are suboptimal. Despite the proven safety and efficacy of vaccines, adult immunization rates are well below public health targets. Only 20% of American adults receive all vaccines recommended by the Centers for Disease Control and Prevention (CDC). Vaccination provides significant protection against avoidable hospitalizations and deaths. Gaps in adult immunization rates continue to limit opportunities to improve overall health nationwide.
Pharmacy-based vaccine access is critical. Community pharmacies are highly accessible and can play a vital role in expanding vaccine uptake, especially among adults.
Despite a trend toward expanded vaccination authority, pharmacy-based vaccine access varies significantly from state to state. The COVID-19 pandemic accelerated an existing trend, with temporary flexibilities paving the way for permanent changes to immunization authority for pharmacy personnel—i.e., pharmacists, pharmacy interns, and pharmacy technicians. Important gaps remain, however.
This presents 50-state research findings (plus Washington, D.C. and Puerto Rico) on the authority for pharmacy personnel to administer adult vaccines, including limits on the list of vaccines they are authorized to administer, as well as other restrictions on access such as the need for a prescription or protocol from a physician or other prescriber. Small variations in state policy language can lead to significant barriers in vaccine access, particularly in the months after a vaccine is newly approved by the Food & Drug Administration (FDA) or receives a new or updated recommendation from the CDC or CDC’s Advisory Committee on Immunization Practices (ACIP).
This presents state policy strategies to make pharmacy-based vaccine access for adults more robust and consistent nationwide. Specifically, state policymakers should consider implementing the following three principles in their policies on adult vaccination authority for pharmacy personnel:
- Define the list of permitted adult vaccines broadly for trained pharmacists by authorizing all adult vaccines that are either:
- Approved or authorized by FDA; or
- Recommended by ACIP, CDC, or state health officials;
- With respect to third-party orders, eliminate or limit requirements for a prescription or prescriber protocol as a precondition for pharmacist vaccinations, and make judicious use of statewide standing orders (SSOs); and
- Authorize pharmacy technicians and pharmacy interns to administer the same set of adult vaccines as pharmacists, subject to appropriate training and pharmacist supervision.
All states have already implemented at least one of these principles, but only 5 states (10%) have implemented all three. Adopting these principles would help improve access to vaccines, close gaps in adult immunization, and improve public health outcomes nationwide.
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For more, join us on Monday, May 11 for a corresponding exploring how variations in state law and regulation can either facilitate or hinder vaccine access and highlights practical policy strategies to expand, stabilize and standardize vaccination authority nationwide. To register for the webinar, click .
