In some states, pharmacists can administer influenza vaccinations. However, laws do differ from state to state. Some states allow pharmacists – who must be certified – to give flu shots based on an established protocol agreed upon with a physician. Other states, such as Oklahoma (until Nov. 1), require patients to obtain a prescription from a doctor before a pharmacist can administer a vaccine.
The differing standards and regulations have the potential of creating barriers to access for vaccinations, something that should be of concern as the H1N1 vaccine makes its way to health care providers.
In Oklahoma, for example, I saw about a dozen people arrive at a pharmacy counter for their flu shots, only to be told they had to get a prescription. Those people left the pharmacy, presumably to visit their doctor, a visit that likely required a co-pay or other payment. Every time someone left, I had to wonder whether they would follow through and return with a prescription. In my case, I went to a walk-in clinic where I only waited a few minutes – though I had to fill out several forms – then had my vitals recorded and answered a series of questions, first from a nurse and then from the doctor. I then returned to the pharmacy, filled out more forms very similar to what I had completed for the doctor and waited until the pharmacist was available to give me a flu shot. The whole process took about two hours – time that many people can’t afford to spend.
Presumably, states are allowing pharmacists to give influenza vaccinations to increase the public’s access and boost immunizations. But are the regulations guiding such vaccinations working or are different barriers being created? It remains to be seen whether pharmacists will be giving H1N1 vaccinations, but a number of organizations are discussing the possibility.
Carolyn C. Ha, Pharm.D., of the National Community Pharmacists Association, has provided a state-by-state breakdown of requirements for pharmacist-provided immunizations.
The Association of State and Territorial Health Officials recently released an “Operational Framework for Partnering with Pharmacies for Administration of 2009 H1N1 Vaccine” that includes information about requirements in each state. (contact: Paula A. Steib, senior director communications, Association of State and Territorial Health Officials, 202-371-9090 ext. 3173)
The American Pharmacists Association has provided information about vaccine distribution. The organization is working with the National Association of Chain Drug Stores, the National Community Pharmacists Association, state associations, CDC, and the Association of State and Territorial Health Officials to get pharmacies included in each state’s 2009 H1N1 influenza virus immunizing program.
The CDC’s has contact information for state/jurisdiction officials and guidelines for clinicians. The CDC’s Advisory Committee on Immunization Practices also will have information about H1N1 vaccinations.
For more about the certification process for pharmacists, read “Incorporating an Immunization Certificate Program into the Pharmacy Curriculum,” from the American Journal of Pharmaceutical Education and from the American Pharmacists Association.